Medicare Part B benefits and coverage costs

For 2026, the standard Medicare Part B premium is $202.90/month.³ (See below for an overview of how Medicare Part B premiums have changed over the years.)

Medicare Part B premiums can be covered by Medicaid if the beneficiary is eligible for both Medicaid and Medicare. And high-income enrollees’ (above $109,000 for a single person in 2026)  premiums are higher than the standard premiums for Medicare Part B.³

Some enrollees don’t have to pay for the for Medicare Part B premium. There are essentially three ways this is possible, and although they aren’t applicable to most Medicare beneficiaries, it’s useful to know what options are available for covering the cost of the premiums. Here are the scenarios:

• Your income and assets are low enough to qualify for full-scope Medicaid (comprehensive coverage under the Medicaid program, in addition to your Medicare coverage) or a Medicare Savings Program that covers the cost of Medicare Part B, or both.⁴ Medicare Savings Programs are run by each state’s Medicaid office, and eligibility varies from one state to another.⁵
• You or your spouse is continuing to work and the employer offers a QSEHRA or an ICHRA that reimburses you for the cost of your Medicare Part B premiums.
• You enroll in a Medicare Advantage plan that has a “giveback” premium reduction that covers your entire Medicare Part B premium. Givebacks are not the norm, but availability of these plans has increased in recent years. In 2025, nearly a third of  Medicare Advantage plans included at least some amount of giveback premium reductions, up from 19% of plans in 2024.⁶ However, the giveback amount can vary from as little as 10 cents per month to as much as the full Part B premium.⁷ So it’s important to understand that many enrollees who get a giveback premium reduction do still have to pay a premium for Part B.

For most enrollees, meaning those who are receiving Social Security benefits and enrolled in Part B, the Social Security Administration deducts Part B premiums from their Social Security checks (this happens automatically, as long as the person is receiving Social Security benefits).⁸ But a “hold harmless” rule prevents net Social Security checks from declining from one year to the next, unless the person has an income high enough to be subject to the income-related surcharges for Medicare Parts B and D.⁹ So if the Medicare Part B premium increases by more than an enrollee’s Social Security cost of living adjustment (COLA), the person’s premium will be adjusted, and will end up being less than the standard amount.

Due to fairly small COLAs, most beneficiaries paid less than the standard amount for Medicare Part B in 2017 (an average of $109/month, versus the standard premium of $134/month) and 2018 (an average of $130/month, versus the standard premium that remained at $134/month). By 2019, CMS estimated that only about 3.5% of Medicare beneficiaries were still paying a lower-than-standard amount for Part B, as COLAs had caught up with standard Part B premium increases by that point. By 2020, virtually all non-high-income Part B enrollees were paying the standard premium for Part B.

For 2026, the standard Part B premium increased by almost $18/month.¹⁰ The Social Security COLA for 2026 is 2.8%, which amounts to an average increase of about $56/month.¹¹ The dollar amount of the COLA is larger for those who receive larger checks, and smaller for those who receive smaller checks. But the hold harmless provision will only be applicable in a case where a 2.8% increase amounts to less than about $18 and thus will not cover the increase in the standard Part B premium.

Enrollees who receive treatment during the year that’s covered by Medicare Part B must pay all costs for covered services until they meet a deductible, which is $283 for 2026.¹⁰ (The deductible amount increased from $257 in 2025. See below for an overview of how the Medicare Part B deductible has changed over time.) After the deductible, enrollees pay 20% of the Medicare-approved amount for care that’s covered under Medicare Part B, although supplemental coverage from a Medigap plan, Medicaid, or an employer-sponsored plan can be used to cover some or all of the Medicare Part B out-of-pocket costs.

Note that the Part B deductible does not apply to certain preventive care that’s covered at zero-cost to the enrollee, even before the deductible is met.¹²

Learn how Medicare premiums, deductibles and coinsurance changed for 2026.

No, not everyone pays the Medicare Part B deductible. People who don’t receive services covered under Medicare Part B do not pay the deductible, as the deductible only applies when services are received (unlike premiums, which have to be paid regardless of whether any medical treatment is needed).

In addition, the Medicare Part B deductible does not apply to certain preventive care, such as vaccines, as long as the patient uses a medical provider who accepts assignment with Medicare (meaning they agree to accept Medicare’s reimbursement rates as payment in full).¹²

Although most Medicare beneficiaries do receive services that are covered under Medicare Part B, some of them do not have to pay the Part B deductible:

• Medigap plans C and F cover the Part B deductible, so if you have one of those plans, you’re not responsible for paying the Medicare Part B deductible out of your own pocket. (Coverage of the Part B deductible is why Medigap Plans C and F have not been available to people who become newly eligible for Medicare after the end of 2019,¹³ under the terms of the Medicare Access and CHIP Reauthorization Act. The idea is that there will be less unnecessary utilization of health care if all Original Medicare enrollees are subject to the Part B deductible.)
• Enrollees who have Medicaid, employer-sponsored health coverage, or retiree health benefits from an employer generally don’t have to pay the full Medicare Part B deductible, as the other coverage may pick up some or all of the out-of-pocket costs you would otherwise have to pay under Original Medicare, including deductibles, copays, and coinsurance (this varies depending on the plan).¹⁴¹⁵
• Some Medicare Advantage plans have no deductibles.
• According to a KFF analysis, about 11% of Original (traditional) Medicare beneficiaries only have Medicare Parts A and B, without supplemental coverage that picks up some of the Part A and Part B cost-sharing.¹⁶ They don’t have Medigap coverage, employer-sponsored coverage, retiree health benefits from a former employer, or Medicaid. These enrollees – along with beneficiaries who have a Medigap plan other than C or F – have to pay the full Part B deductible if and when they need services (other than zero-cost preventive care) that are covered under Medicare Part B (assuming the cost of their care reaches at least the amount of the Part B deductible; if the only care they receive costs less than the Part B deductible, they only pay for the care they receive).

If you are already receiving Social Security or Railroad Retirement benefits, you will be notified three months prior to the month you turn 65 that you are about to be enrolled in Medicare Part A, and that Medicare Part B is an option. You’ll receive the Medicare Part B card at the same time as the Medicare Part A card.¹⁷

If you choose not to enroll in Medicare Part B, you must return the card or the premium will automatically start to be deducted from your Social Security checks. (Returning the card means you’re rejecting Medicare Part B coverage. Read more about that below.) If you keep the card, Medicare Part B coverage kicks in the month you turn 65.

If you’re not already receiving Social Security or Railroad Retirement benefits, you’ll have an opportunity to enroll in Medicare B (along with Medicare Part A) during a seven-month Initial Enrollment Period (IEP).¹⁸

It’s important to note that if you fail to enroll in Medicare Part B during the IEP, you’ll have another opportunity to enroll each succeeding year (January 1 – March 31), with coverage effective the month after you enroll. (The effective date used to be July 1, but this changed as of 2023, under the BENES Act.)¹⁹ The catch? If and when you do eventually enroll in Medicare Part B, your monthly premium will be increased by 10% for each year that you were eligible for Part B but turned it down. This higher rate will be in place for as long as you have Medicare Part B.²⁰

So if you wait three full years to enroll after your IEP, you’ll pay premiums that are 30% higher than the standard Part B premium for that year, for as long as you have Medicare Part B coverage (generally, for life). The penalty does not apply, however, if you delay your Part B enrollment because you have other coverage in place from a current employer or your spouse’s current employer.

Enrollment in Medicare Part B is optional. You can choose not to enroll in Part B and thus avoid the Part B premiums. But that would mean you’re responsible for negotiating and paying the cost of any services that would otherwise be covered under Medicare Part B. For some folks, that might amount to the occasional office visit and nothing more. But if you end up needing extensive outpatient care – such as kidney dialysis, chemotherapy, radiation or physical therapy – your bills could add up quickly.

As noted above in the discussion about late enrollments, you will have a chance to sign up for Medicare Part B each year, regardless of how long you’ve delayed enrollment. But the late-enrollment penalty could become substantial, depending on how long you’ve waited to enroll. And if and when you do decide to enroll, you’ll have to wait until the next General Enrollment Period. So going without Medicare Part B when you don’t have other coverage from a current employer’s plan is an option, but you risk higher premium costs and a window of time when you may need coverage but don’t have access to it (the GEP runs from January to March each year; if you decide you want Part B in April, you’ll have to wait until the following January to enroll, with coverage effective in February).

The standard Medicare Part B premium has generally increased over time, although there have been some years when it stayed the same or even decreased. Here’s a historical summary of standard Medicare Part B premiums (not applicable to those subject to the “hold harmless” rule or IRMAA) over the last several years:²⁵

• 2006: $88.50
• 2007: $93.50
• 2008: $96.40
• 2009: $96.40
• 2010: $110.50
• 2011: $115.40
• 2012: $99.90 (decrease)
• 2013: $104.90
• 2014: $104.90
• 2015: $104.90
• 2016: $121.80
• 2017: $134.00
• 2018: $134.00
• 2019: $135.50
• 2020: $144.60
• 2021: $148.50
• 2022: $170.10
• 2023: $164.90 (decrease)
• 2024: $174.70
• 2025: $185
• 2026: $202.90

The Medicare Part B deductible has generally increased over time, although there have been some years when it stayed the same or even decreased. The increase for 2022 was the largest year-over-year dollar increase in the program’s history. But the decrease for 2023 was the first time the deductible had declined in over a decade. Here’s a historical summary of Medicare Part B deductibles over the last several years:²⁶

• 2005: $110
• 2006: $124
• 2007: $131
• 2008: $135
• 2009: $135
• 2010: $155
• 2011: $162
• 2012: $140 (decrease)
• 2013: $147
• 2014: $147
• 2015: $147
• 2016: $166
• 2017: $183
• 2018: $183
• 2019: $185
• 2020: $198
• 2021: $203
• 2022: $233
• 2023: $226 (decrease)
• 2024: $240
• 2025: $257
• 2026: $283