Part B, also called medical insurance, is part of Original Medicare (the government’s Fee-for-Service program). It helps cover services from doctors and other healthcare providers, such as outpatient care, lab tests, and some home health care.
Part B also covers durable medical equipment like wheelchairs, walkers, and hospital beds, and many preventive services like screenings and shots.
All Medicare Advantage plans must include standard Part B coverage.
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Some things to think about with Part B
- Part B is optional. You are not required to enroll in it, but most people do choose to get it because it covers care costs that Part A (hospital insurance) does not cover.
- You will pay a monthly premium. For 2026, the premium is projected to start at $206.50/month. Exact figures will be announced by the CMS on September 30, 2025.
- There is no maximum out-of-pocket limit, so there is no limit to how much you will pay annually for care. This means if you have a lot of doctor visits, tests, or long hospital stays, your costs (deductibles, coinsurance, copayments) can keep adding up. There is no maximum limit where Medicare says, “You’ve paid enough, now we’ll cover 100%.”
- You will pay 20% coinsurance for your care.
- Part B offers an initial preventive exam when you join Medicare. However, it does not cover an Annual Wellness Visit which is covered in Medicare Advantage plans.
- Part B does not cover prescription drugs. If you want prescription drug coverage you will have to buy a Medicare Part D drug plan or select a Medicare Advantage plan.
- You can see any health care provider who accepts Original Medicare.
(Note: Not all doctors accept Original Medicare. Before your visit, always ask if the doctor takes Medicare. If they don’t, you may have to pay the full cost yourself.)
- Par B does not cover costs a healthcare provider may charge if they want to charge more than what the government (Medicare) agrees to pay for care.
- Doctors are paid for the volume of services they provide. They are not incented to help keep you healthy by providing care based on proven national quality standards, although some may participate in a Medicare Shared Savings Program (MSSP) that will reward them for keeping their patients healthier.
- Doctors generally do not work together to coordinate and discuss care plans.
Did you know?
Many people do not know that Original Medicare (Part A and Part B) doesn’t cover everything. You can purchase a Medicare Supplement (Medigap) plan to help cover what Original Medicare doesn’t cover. But even Medicare Supplement plans with 100% coverage do not cover everything.
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