Medicare Part B

What is Medicare Part B Insurance?

Medicare Part B (medical insurance) is part of Original Medicare and covers medical services and supplies that are medically necessary to treat your health condition.

This part of Medicare covers doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance transportation, and other outpatient services.

Unlike Part A, Part B involves more costs, and you may want to defer signing up for it if you are still working and have insurance through your job or are covered by your spouse’s health plan. But if you don’t have other insurance and don’t sign up for Part B when you first enroll in Medicare, you’ll likely have to pay a higher monthly premium for as long as you’re in the program.

How much does Medicare Part B Insurance cost?

The federal government sets the Part B monthly premium, which is $202.90 in 2026. It may be higher if your income is more than $109,000 for individuals and $218,000 for married couples.

You’ll also be subject to an annual deductible, set at $283 for 2026. After the deductible, you’ll pay 20 percent of the bills for doctor visits and other outpatient services. If you are collecting Social Security, the monthly premium will be deducted from your monthly benefit.

Medicare Part B Insurance FAQs

Can I delay enrolling in Medicare Part B?
Some people may get Medicare Part A “premium-free,” but most people  pay a monthly premium for Medicare Part B. Because Medicare Part B comes with a monthly premium, some people may choose not to sign up during their initial enrollment period if they are currently covered under an employer group plan (either their own or through their spouse’s employer).

If you are still working, you should check with your health benefits administrator to see how your insurance would work with Medicare.

If you delay enrollment in Medicare Part B because you already have current employer health coverage, you can sign up later during a Special Enrollment Period without paying a late penalty. You can enroll in Medicare Part B at any time that you are still covered by a group plan based on current employment. After your employer health coverage ends or your employment ends (whichever comes first), you have an eight-month special enrollment period to sign up for Part B without a late penalty.

Keep in mind that retiree coverage and COBRA are not considered health coverage based on current employment and would not qualify you for a special enrollment period. If you have COBRA after your employer coverage ends, you should not wait until your COBRA coverage ends to sign up for Medicare Part B. Your eight-month Part B special enrollment period begins immediately after your current employment or group plan ends (whichever comes first). This is regardless of whether you get COBRA.

What services are not covered by Part B?
There are some services that are not covered by Part B. If you need these services, you’ll pay for them out of pocket. Some examples of these include:
  • routine physical examinations
  • most prescription drugs
  • dental care, including dentures
  • most vision care, including eyeglasses or contact lenses
  • hearing aids
  • long-term care
  • cosmetic surgery
  • alternative health services like acupuncture and massage

If you’d like prescription drug coverage, you can purchase a Medicare Part D plan. Part D plans are offered by private insurance companies and include most prescription drugs.

Additionally, Medicare Part C (Medicare Advantage) plans include all services covered under original Medicare, as well as some additional services like dental, vision, and even fitness programs. If you know you’ll need these services frequently, consider a Part C plan.

When can I apply?
Initial enrollment period. This is a 7-month window around your 65th birthday when you can sign up for Medicare. It begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birthday. During this time, you can enroll for all parts of Medicare without a penalty.

Annual enrollment period (October 15–December 7). During this time, you can change from original Medicare (parts A and B) to Part C (Medicare Advantage), or from Part C back to original Medicare.  You can change Part C plans.  You can also add or change to a Medicare Supplement policy (Health Underwriting may be required for these plans).  Additionally, you can add, remove, or change a Part D plan.

General enrollment period (January 1–March 31). If you are enrolled in Medicare Part C (Medicare Advantage) you can change to another Part C (Medicare Advantage) plan, or from Part C back to original Medicare.  You can make one change each year during the General enrollment period.

Special enrollment period. If you delayed Medicare enrollment for an approved reason, you can later enroll during a special enrollment period. You have 8 months from the end of your coverage or the end of your employment to sign up without penalty.

Medicare can be complicated, and there are many factors to consider to determine the right fit for you. We can help guide you.

Learn More About Our Team

Shane Quintana, LUTCF
Business and Estate Planning Specialist
About Shane
Donna Quintana, RHU
Employee Benefits and Health Insurance Specialist
About Donna

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The information provided herein has been obtained from sources believed to be reliable. The Quintana Group makes no representation as to its accuracy or completeness and it should not be relied upon as such.

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The Quintana Group is not connected with or endorsed by the U.S. Government or with the federal Medicare program. We do not offer every plan available in your area. Currently, we represent 10 organizations in 2 states which offer 46 plans (plan availability depends on the zip code in which you reside). Please contact Medicare.gov, 1-800-Medicare or your local State Health Insurance Program (SHIP) to get information on all of your options.

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