Medicare Part B

Covers physician services, outpatient care, durable medical equipment, and most preventive services. Requires a monthly premium (standard rate ~$185 in 2026, higher for high-income beneficiaries) and has a deductible plus 20% coinsurance for most services after deductible.

What it means in practice

Part B has a $257 annual deductible in 2026, then Medicare pays 80% and the patient pays 20% coinsurance for most services. The standard Part B premium is $185/month in 2026, increasing for higher-income beneficiaries (the "IRMAA" surcharge, based on tax returns from 2 years prior). Premiums are typically deducted from Social Security checks.

The 20% coinsurance has no annual cap — for a patient with major surgery, advanced cancer treatment, or hospitalization with significant Part B services (physician fees, anesthesia, imaging), 20% can be tens of thousands of dollars. This uncapped exposure is the main reason most patients on original Medicare buy a Medigap policy (which covers most or all of the 20%) OR enroll in a Medicare Advantage plan (which has a hard out-of-pocket cap, typically $4,000–$9,350).

Part B preventive services are usually 100% covered — annual wellness visit, mammogram, colonoscopy, prostate screening, flu shot, COVID vaccine, diabetes screening for high-risk patients. The annual wellness visit is NOT the same as a physical exam; it's a Medicare-defined preventive encounter that doesn't include a hands-on exam. The difference catches families off-guard when the doctor's office bills separately for the "physical" portion.

Durable medical equipment (DME) — walkers, wheelchairs, hospital beds, oxygen, CPAP — is Part B, with the standard 20% coinsurance. The DME supplier has to be Medicare-enrolled and the prescription has to meet specific medical-necessity criteria.

When you'll hear it

Doctor visits, blood draws, outpatient procedures, durable medical equipment (DME) prescriptions. Most patients combine Part B with either Medigap or Part C.

Is this the same as…?

Terms families frequently confuse with medicare part b.

Related terms

• Medicare Part A — The federal program that covers hospital stays, skilled nursing facility (SNF) stays after qualifying hospitalizations, hospice, and some home health care for people 65+ (and some younger people with disabilities).
• Medicare Advantage — A private-insurance alternative to original Medicare (Parts A + B), bundling the coverage with extras like prescription drugs, vision, dental, gym memberships, and sometimes meal delivery.
• Medigap — Private supplemental insurance designed to cover the deductibles and coinsurance that original Medicare (Parts A + B) doesn't.
• Medicare Part D — Prescription drug coverage.
• Durable medical equipment — Reusable medical equipment for long-term use at home: wheelchairs, walkers, hospital beds, oxygen concentrators, CPAP machines, glucose meters, lift chairs, etc.
• Out-of-pocket maximum — The maximum amount you pay out of pocket in a plan year before insurance covers 100% of in-network care.

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