Medicare Part B – Medical Insurance
What It Is
Section titled “What It Is”Medicare Part B is the portion of Medicare that covers outpatient and medical services. It’s often called “medical insurance” because it pays for doctor visits, preventive care, and treatments outside of hospital stays.
What Part B Covers
Section titled “What Part B Covers”Doctor Visits
Section titled “Doctor Visits”- Primary care and specialists.
- Office visits, consultations, and follow-ups.
Outpatient Care
Section titled “Outpatient Care”- Services received without being admitted to a hospital.
- Includes surgeries, diagnostic tests, and lab work.
Preventive Services
Section titled “Preventive Services”- Screenings (cancer, diabetes, heart disease).
- Vaccinations (flu, pneumonia, COVID-19).
- Annual wellness visits.
Durable Medical Equipment (DME)
Section titled “Durable Medical Equipment (DME)”- Wheelchairs, walkers, oxygen equipment, and other medically necessary supplies.
Home Health Services
Section titled “Home Health Services”- Limited coverage for skilled nursing, physical therapy, or speech therapy at home.
Costs Associated with Part B
Section titled “Costs Associated with Part B”Premiums
Section titled “Premiums”- Standard monthly premium ($202.90 in 2026).
- Higher-income beneficiaries may pay more (Income-Related Monthly Adjustment Amount, IRMAA).
Deductible
Section titled “Deductible”- Annual deductible ($283 in 2026).
Coinsurance
Section titled “Coinsurance”- Typically 20% of the Medicare-approved amount for most services after the deductible is met.
Example:
If a doctor visit costs $100, Medicare pays $80 and you pay $20.
Enrollment & Penalties
Section titled “Enrollment & Penalties”- Most people enroll in Part B during their Initial Enrollment Period (IEP). You can delay enrollment if you have qualifying employer-sponsored coverage.
- Late Enrollment Penalty: Your premium increases by 10% for each 12-month period you were eligible but did not enroll—and you pay that penalty for life.
Why Part B Matters
Section titled “Why Part B Matters”- Provides coverage for everyday medical needs that Part A doesn’t cover.
- Ensures access to preventive care, helping detect and manage conditions early.
- Complements Part A to form the foundation of Original Medicare.
Consumer Takeaway
Section titled “Consumer Takeaway”Medicare Part B is your medical insurance, covering doctor visits, outpatient care, preventive services, durable medical equipment, and more. It requires a monthly premium and cost-sharing, but it’s essential for comprehensive coverage alongside Part A.