Medicare Part B (Medical Insurance) covers 80% of outpatient services after the $283 annual deductible (2026). Standard premium is $202.90/month, with 20% coinsurance on doctor visits, tests, and in office drugs (I.e. chemotherapy) and equipment creating unlimited exposure without supplemental coverage.
Medicare Part B: Medical Insurance Complete Guide
How Part B Costs Work
$283 deductible (once/year) → Part B pays 80% → You pay 20% FOREVER
| Service | Medicare Approved | Part B Pays (80%) | You Pay 20% |
|---|---|---|---|
| Doctor Visit | $200 | $160 | $40 |
| MRI | $2,500 | $2,000 | $500 |
| Outpatient Surgery | $15,000 | $12,000 | $3,000 |
High-Income IRMAA Premiums, can increase Part B monthly premiums $284.10/mo or $689.90/month. Income and married status vary which determine when this occurs.
Part B Enrollment Rules (Penalty Warning)
Automatic: With Social Security at 65
Manual: 3 months before, the month of your 65th birthday, the 3 months after. Total of 7 months to enroll
Late Penalty: 10% PER YEAR LATE (permanent)
Example: 2 years late = $40.58/month extra FOREVER
Frequently Asked Questions
Do I have to take Part B?
Yes if not working/employer coverage. No penalty if employer >20 employees primary and their coverage is determined to be qualifying coverage.
What triggers 20% coinsurance?
Every service after $283 deductible: doctor, tests, ER, outpatient surgery.
Does Part B have an out-of-pocket maximum?
NO — unlimited 20% exposure without Medigap/Part C.
Can I opt out later?
Yes, during Annual Enrollment (Oct 15–Dec 7) but risk penalty reinstatement that is permanent.
Part B + employer insurance?
Employer primary if >20 employees; coordinate carefully.
Stop 20% Coinsurance Bleeding
Get Quotes for Protection:
- Medicare Advantage with Part D coverage (Maximum Out of Pocket varies by plan but replaces unlimited 20%)
- Medigap Plans G/N (covers 100% coinsurance, just a one-time annual deductible beyond the plans monthly premium.)
Serving Medicare beneficiaries nationwide.
MEDICARE DISCLAIMER: It’s possible that we do not offer every plan in your area. We represent a number of Medicare Advantage organizations throughout the country which offer products in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.