Medicare Part B

Premium and Deductible

Medicare Part B encompasses a variety of services, including those provided by physicians, outpatient hospitals, specific home health services, durable medical equipment, and other essential medical and health services that Medicare Part A does not cover. Each year, the premiums, deductibles, and coinsurance rates for Medicare Part B are set in accordance with the Social Security Act. For 2026, the standard monthly premium for Medicare Part B participants is set at $202.90, reflecting an increase of $17.90 from the previous year’s premium of $185.

Additionally, the annual deductible for all Medicare Part B beneficiaries will rise to $283 in 2026, up by $26 from the 2025 amount of $257. This adjustment in the standard premium and deductible for 2026 is primarily attributed to anticipated changes in prices and expected increases in service utilization, aligning with trends observed in historical data. If the Trump Administration had not taken action to address unprecedented spending on skin substitutes, the Part B premium increase would have been about $11 more a month. However, due to changes finalized in the 2026 Physician Fee Schedule Final Rule, spending on skin substitutes is expected to drop by 90% without affecting patient care.

Beginning in 2023, individuals whose full Medicare coverage ended 36 months after a kidney transplant, and who do not have certain other types of insurance coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2026, the standard immunosuppressive drug premium is $121.60.

The income-related monthly adjustment amounts, established since 2007, have implications for approximately 8% of Medicare Part B beneficiaries, and the 2026 total premiums for high-income participants with full Part B coverage, as well as those with solely immunosuppressive drug coverage, are detailed in the accompanying tables. Part B Immunosuppressive Drug Coverage Only

Premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

What you need to know about Part B:

• Coverage: Medicare Part B covers two types of services:
  • Medically necessary services: These are services or supplies that are needed to diagnose or treat a medical condition and that meet accepted standards of medical practice.
  • Preventive services: These are health care services that prevent illness or detect illnesses at an early stage, when treatment is likely to work best (like flu shots and screening tests).
• More specifically, Part B covers things like:
  • Clinical research
  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Some outpatient prescription drugs
  • Doctor visits
  • Physical therapy
  • Laboratory tests
  • X-rays
• Cost: Beneficiaries typically pay a monthly premium for Part B. The premium amount can vary based on income. In addition to the monthly premium, there’s an annual deductible. After the deductible is met, beneficiaries typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
• Enrollment: Enrollment in Part B is optional. Some people automatically get Part B, but others need to sign up for it. If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have the coverage.
• Late Enrollment Penalty: If you don’t sign up for Part B when you’re first eligible, you might have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium could go up 10% for each 12-month period you were eligible for Part B but didn’t sign up for it.

Medicare Part B, in essence, is an essential component of the Medicare program, providing coverage for a broad range of outpatient medical services.

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