Medicare Part B is the medical insurance part of Original Medicare. It helps pay for doctor visits, outpatient care, preventive services and equipment such as walkers. In 2026 the standard Part B premium is $202.90 a month and the yearly deductible is $283, after which you usually pay 20% of the Medicare-approved amount.
What is Medicare Part B, and what does it cover?
Part B is the part of Medicare that covers care outside a hospital stay. CMS describes it as covering physicians’ services, outpatient hospital services, certain home health services, durable medical equipment and certain other medical services that Part A does not. Medicare.gov groups it into two kinds of care: medically necessary services, and preventive services.
Examples include:
- doctor visits and other outpatient care
- ambulance services
- durable medical equipment, such as walkers, wheelchairs, hospital beds, glucose monitors and oxygen equipment
- outpatient mental health care
- a limited set of outpatient prescription drugs
The preventive list includes the “Welcome to Medicare” visit, a yearly wellness visit, flu, COVID-19, pneumococcal and hepatitis B vaccines, and screenings such as mammograms, colorectal cancer, diabetes, depression and lung cancer screenings. You pay nothing for most preventive services when the provider accepts assignment, meaning the provider agrees to take the Medicare-approved amount as full payment. Our senior vaccines guide covers the shots.
What is the Part B deductible for 2026, and what else will you pay?
The Part B deductible is $283 in 2026, up from $257 in 2025, according to the CMS fact sheet. You pay it once a year before Original Medicare starts paying. The monthly premium is separate and due even in a month when you use no services.
| Part B cost, 2026 | What you pay |
|---|---|
| Standard monthly premium | $202.90 (more at higher incomes, see below) |
| Yearly deductible | $283 |
| Most covered services, after the deductible | Usually 20% of the Medicare-approved amount, if the provider accepts assignment |
| Covered clinical laboratory services | $0 |
| Covered home health services | $0 |
| Durable medical equipment | 20% of the Medicare-approved amount |
| Services in a hospital outpatient department | 20%, plus a copayment to the hospital in most cases |
| Yearly out-of-pocket limit | None in Original Medicare, unless you add a Medigap policy or join a Medicare Advantage plan |
Source: Medicare.gov, Medicare costs. Medicare Advantage members must keep Part B and its premium, but the plan sets its own copayments and limits.
What does Part B not cover?
Medicare.gov says Original Medicare generally does not cover routine dental care such as cleanings, fillings and dentures, routine eye exams for glasses, or hearing aids. It also does not pay for long-term custodial care, 24-hour care at home, home meal delivery or homemaker services unrelated to the care plan. Our guides to Medicare and home care in New York and Medicare versus Medicaid explain what fills those gaps.
Who is eligible for Medicare Part B?
Medicare.gov says Medicare is health insurance for people 65 or older who meet citizenship or residency requirements. You must be a U.S. citizen or national, a lawful permanent resident, a Cuban-Haitian entrant, or lawfully living in the U.S. under the Compacts of Free Association. You can qualify before 65 if you have a disability, End-Stage Renal Disease or ALS. After 24 months of Social Security disability benefits you become eligible, and with ALS eligibility starts as soon as benefits start.
When can you sign up for Medicare Part B?
There are three kinds of sign-up windows, and the one you are in decides whether a penalty applies.
| Window | When it is | When coverage starts |
|---|---|---|
| Initial Enrollment Period | 7 months: 3 months before the month you turn 65, the birthday month, and 3 months after | Sign up before your birthday month: the month you turn 65. Sign up in your birthday month or in the 3 months after: the next month |
| General Enrollment Period | January 1 to March 31 each year, for people who missed other windows | The month after you sign up. A late penalty may apply |
| Special Enrollment Period | Specific situations, for example job-based coverage (up to 8 months after the job or the coverage ends, whichever comes first) or losing Medicaid (6 months) | Generally the month after you sign up |
Source: Medicare.gov, When does Medicare coverage start?. Coverage always starts on the first of a month. Medicare.gov also lists Special Enrollment Periods for declared disasters, wrong information from a plan or employer, and release from incarceration. Those requests go to Social Security on form CMS-10797.
Some people do not need to sign up at all. If you start getting Social Security benefits at least 4 months before you turn 65, you automatically get Part A and Part B, and Medicare mails the card about 3 months before coverage starts. People who still have job-based coverage may choose to wait on Part B. Medicare.gov’s sign-up questions turn on whether you or your spouse still work and whether the employer has 20 or more employees, so ask the employer’s benefits office before you decide.
How do you apply for Medicare Part B?
Medicare.gov says the easiest and fastest route is online through Social Security. This is the usual sequence if Part B does not start automatically.
- Find out which window you are in. Count from your 65th birthday month, or check whether you are in a Special Enrollment Period. Medicare.gov has a short sign-up date questionnaire.
- Get your paperwork ready. If you are using a Special Enrollment Period for job-based coverage, Medicare.gov says you must fill out an extra form showing you had that coverage while you or your spouse worked.
- Apply with Social Security. Use your secure my Social Security account online, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or contact your local Social Security office. If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
- Watch for your card. About 2 weeks after you sign up, Medicare mails a welcome package with your Medicare card.
- Check your start date. Use the table above, then confirm the month on your notice. Coverage starts on the first of a month.
If you already have Part A, Medicare.gov points you to Social Security’s online application or a paper form for people who have Part A and want to add Part B. ssa.gov was not reachable for our automated check, so confirm the current form and steps on the Social Security site or by phone. You can also call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).
What is the Part B late enrollment penalty?
If you could have signed up for Part B and did not, and no Special Enrollment Period applies, Medicare.gov says you pay an extra 10% for each full 12-month period you could have had Part B. It is added to your premium for as long as you have Part B.
Medicare.gov’s example: someone who waited 2 full years pays a 20% penalty. In 2026 that is $202.90 plus $40.58, rounded to $243.50 a month. You generally avoid the penalty if you qualify for a Special Enrollment Period or enroll in a Medicare Savings Program.
Does your income change the Part B premium?
Yes. High earners pay an income-related monthly adjustment amount, often called IRMAA. According to CMS, it affects roughly 8% of people with Part B. For 2026, Social Security looks at the modified adjusted gross income on your tax return from 2 years earlier, so 2024 income sets the 2026 amount.
| 2024 income, single filer | 2024 income, joint filers | Total Part B premium per month in 2026 |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| Above $109,000 up to $137,000 | Above $218,000 up to $274,000 | $284.10 |
| Above $137,000 up to $171,000 | Above $274,000 up to $342,000 | $405.80 |
| Above $171,000 up to $205,000 | Above $342,000 up to $410,000 | $527.50 |
| Above $205,000 and under $500,000 | Above $410,000 and under $750,000 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
Source: CMS 2026 fact sheet. People who are married, file separately and lived with their spouse during the year have their own, narrower table: above $109,000 and under $391,000 is $649.20, and $391,000 or more is $689.90. Social Security tells you if you owe the higher amount. If a life-changing event has lowered your household income, Medicare.gov says you can ask Social Security to reduce the extra amount.
How do you pay the Part B premium?
Most people have it taken out of their monthly Social Security payment (or Railroad Retirement Board payment), with nothing to set up. If you do not get those benefits, Medicare sends a bill every 3 months for Part B. Bills are due on the 25th of the month. You can pay through your Medicare account, your bank’s bill-pay service, by mail, or through Medicare Easy Pay, which draws from your bank account on the 20th. Easy Pay can take 6 to 8 weeks to start, and Medicare.gov warns that a late payment can risk your coverage.
Who helps pay the Part B premium in New York?
If your income and savings are limited, the state may pay all or part of your Part B costs. Medicare.gov says you apply through your state, which decides which program fits, and encourages people to apply even if they do not think they qualify. The New York State Department of Health page for 2026 lists the programs below.
Medicare.gov also notes that in most cases the state pays your Part B premium while you have Medicaid, and that you generally avoid the Part B late penalty once you are enrolled in a Medicare Savings Program. The table shows the three programs that pay the premium without full Medicaid.
| Program | What it helps pay | New York 2026 monthly income limit (single / couple) |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium, plus Part A and B deductibles and coinsurance | $1,836 / $2,489 |
| QI (Qualifying Individual) | Part B premium only. Cannot be combined with Medicaid. Funds are limited each year | $2,474 / $3,355 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only. Federal limits are $1,616 / $2,184 and $9,950 / $14,910 in resources | Not listed on New York’s page. Ask the state which program applies |
New York counts $20 less of your income than the amounts shown, which raises each practical limit by $20. Medicare.gov says QI is first-come, first-served and you must reapply every year. To apply, use form DOH-4328 from the local Department of Social Services (in New York City, HRA) or apply online through NY State of Health. The Medicaid Helpline is 1-800-541-2831. Our Medicare versus Medicaid guide gives more detail, and financial help for seniors in NYC lists other programs. For free, unbiased counseling, New York’s HIICAP program is at 1-800-701-0501 through SHIP.
How does Part B work with home health care?
Medicare pays for home health under Part A and Part B, and covered home health services cost you $0. To qualify, you must be homebound, need part-time or intermittent skilled care, and have a doctor or other provider who sees you in person and orders the care from a Medicare-certified agency. The medical equipment that comes with a home health plan is different: Part B pays for durable medical equipment after the deductible, with 20% coinsurance.
Part B is not a long-term home care benefit, and help with bathing, dressing or supervision as the only need is not covered. Our Medicare home health benefit guide explains the 60-day periods and how to appeal, and this guide to medical equipment in New York covers other ways to get equipment.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. We cannot choose a Medicare plan or enrollment date for you, but we can talk through what care at home your family needs and which of it Medicare is unlikely to pay for. Call (718) 232-2777 or use our contact page.
Medicare amounts change every year. The 2026 figures here were checked on 14 October 2026 against medicare.gov, cms.gov, health.ny.gov and shiphelp.org, and the 2026 CMS fact sheet is dated November 14, 2025. Social Security’s own pages (ssa.gov) were not available for our automated check, so confirm enrollment steps with Social Security or 1-800-MEDICARE. This page is general information, not insurance, legal or medical advice.
Frequently asked questions
What is the Medicare Part B deductible for 2026?
$283, up from $257 in 2025. You pay it once a year. After that, Original Medicare usually pays 80% of the approved amount and you pay 20% for most covered services.
What is Part B Medicare?
Part B is Medicare’s medical insurance. It covers medically necessary doctor and outpatient services, preventive care, durable medical equipment and certain home health services. It has a monthly premium, $202.90 in 2026 for most people.
How do I apply for Medicare Part B?
Apply through Social Security, online with a my Social Security account, by phone at 1-800-772-1213, or at a local office. If you started Social Security benefits at least 4 months before turning 65, you get Part B automatically.
When can I sign up for Medicare Part B?
Your Initial Enrollment Period runs 7 months, from 3 months before the month you turn 65 to 3 months after it. Later, you can sign up January 1 to March 31 each year, or in a Special Enrollment Period if you qualify.
How much is the Part B late enrollment penalty?
10% of the standard premium for each full 12-month period you could have enrolled and did not. It is added to your premium for as long as you have Part B. Two full years late means 20%, or $243.50 a month in 2026.
Does Medicaid pay the Part B premium in New York?
Medicare.gov says that in most cases your state pays your monthly Part B premium while you have Medicaid. If you do not qualify for full Medicaid, QMB, SLMB or QI may help. Ask the Medicaid Helpline at 1-800-541-2831.
Does Part B cover home health care?
Yes, for covered skilled home health when you meet Medicare’s tests, with $0 cost for the services. Part B does not pay for 24-hour care or for custodial help with bathing and dressing as your only care.
