{"id":42,"date":"2015-07-20T15:50:31","date_gmt":"2015-07-20T15:50:31","guid":{"rendered":"https:\/\/medicarereport.org\/?page_id=42"},"modified":"2025-11-17T11:05:58","modified_gmt":"2025-11-17T16:05:58","slug":"part-b","status":"publish","type":"page","link":"https:\/\/medicarereport.org\/?page_id=42","title":{"rendered":"Medicare Part B – Medical Insurance"},"content":{"rendered":"

According to the Social Security Administration (2014b), anyone who is eligible for premium-free part A can enroll in Part B with a monthly premium. If you are not eligible for premium-free Part A, you can receive Part B if you are a U.S. citizen or \u201ca lawfully admitted non-citizen who has lived in the United States for at least five years\u201d (p. 7). Medicare Part B is completely voluntary and not funded by payroll taxes; therefore, enrollees must pay a monthly premium. These premiums are typically deducted from the enrollee\u2019s Social Security check, unless there is a special circumstance (i.e. the beneficiary does not receive Social Security payments or the Social Security payment is lower than the cost of the Part B premium). The premium is determined by the Office of the Actuary each year to cover 25% of Part B costs, while 75% of the costs are paid for through general revenues (Learn about, 2012; SSA, 2013; Van de Water, 2013). These premiums are deposited into the Supplemental Medical Insurance (SMI) Trust Fund, which also receives a small amount of financial from special payments by states and from prescription drug manufacturer fees (Lew et al., 2014).<\/p>\n

Original Medicare Part B \u201chelps cover medically necessary doctors\u2019 services, outpatient care, home health services, durable medical equipment, and other medical services\u201d (DHHS, 2014, p. 40). Most preventive services are also covered, including a \u201cwellness screening\u201d once per year. If you have Original Medicare, you are required to pay the Part B deductible, which is $283 per month in 2026. After that, you typically pay 20% of the cost of the service. Wellness visits do not require a deductible or copay. During the first year of having Part B, you can have a \u201cWelcome to Medicare\u201d preventive visit that includes a review of your medical history, as well as education and counseling about preventive services. After that you can receive an annual wellness visit that includes a \u201cHealth Risk Assessment\u201d. This visit is only covered once every 12 months (DHHS, 2014).<\/p>\n

Beginning in 2023, individuals whose full Medicare coverage ended 36 months after a kidney transplant, and who do not have certain other types of insurance coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2026, the standard immunosuppressive drug premium is $121.60.<\/p>\n

There are a variety of services covered by Part B; however, there is also a lot that is not covered. These health services include most dental care; eye exams related to prescribing glasses; dentures; cosmetic surgery; acupuncture; hearing aids and exams to fit hearing aids; and long-term care (DHHS, 2014). Many people who want these additional services or who want to pay lower deductibles and copays will purchase Medicare Advantage or Medigap.<\/p>\n

The income amount used to determine your premium is based on two years earlier. In other words, your 2024 income is used to determine your 2026 re shown below.<\/p>\n

Since 2007, a beneficiary\u2019s Part B monthly premium has been based on his or her income. These income-related monthly adjustment amounts affect roughly 8% of people with Medicare Part B. The 2026 Part B total premiums for high-income beneficiaries with full Part B coverage are shown in the following table:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\n

Full Part B Coverage<\/strong><\/p>\n<\/th>\n<\/tr>\n<\/thead>\n

Beneficiaries who file individual tax returns with modified adjusted gross\u00a0income:<\/strong><\/td>\nBeneficiaries who file joint tax returns with modified adjusted gross income:<\/strong><\/td>\n\n

Income-Related Monthly Adjustment Amount<\/strong><\/p>\n<\/td>\n

\n

Total Monthly Premium Amount<\/strong><\/p>\n<\/td>\n<\/tr>\n

Less than or equal to $109,000<\/td>\nLess than or equal to $218,000<\/td>\n\n

$0.00<\/p>\n<\/td>\n

\n

$202.90<\/p>\n<\/td>\n<\/tr>\n

Greater than $109,000 and less than or equal to $137,000<\/td>\nGreater than $218,000 and less than or equal to $274,000<\/td>\n\n

$81.20<\/p>\n<\/td>\n

\n

$284.10<\/p>\n<\/td>\n<\/tr>\n

Greater than $137,000 and less than or equal to $171,000<\/td>\nGreater than $274,000 and less than or equal to $342,000<\/td>\n\n

$202.90<\/p>\n<\/td>\n

\n

$405.80<\/p>\n<\/td>\n<\/tr>\n

Greater than $171,000 and less than or equal to $205,000<\/td>\nGreater than $342,000 and less than or equal to $410,000<\/td>\n\n

$324.60<\/p>\n<\/td>\n

\n

$527.50<\/p>\n<\/td>\n<\/tr>\n

Greater than $205,000 and less than $500,000<\/td>\nGreater than $410,000 and less than $750,000<\/td>\n\n

$446.30<\/p>\n<\/td>\n

\n

$649.20<\/p>\n<\/td>\n<\/tr>\n

Greater than or equal to $500,000<\/td>\nGreater than or equal to $750,000<\/td>\n\n

$487.00<\/p>\n<\/td>\n

\n

$689.90<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

The 2026 Part B total premiums for high-income beneficiaries who only have immunosuppressive drug coverage under Part B are shown in the following table:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\n

Part B Immunosuppressive Drug\u00a0Coverage Only<\/strong><\/p>\n<\/th>\n<\/tr>\n<\/thead>\n

Beneficiaries who file individual tax returns with modified adjusted gross\u00a0income:<\/strong><\/td>\nBeneficiaries who file joint tax returns with modified adjusted gross income:<\/strong><\/td>\n\n

Income-Related Monthly Adjustment Amount<\/strong><\/p>\n<\/td>\n

\n

Total Monthly Premium Amount<\/strong><\/p>\n<\/td>\n<\/tr>\n

Less than or equal to $109,000<\/td>\nLess than or equal to $218,000<\/td>\n\n

$0.00<\/p>\n<\/td>\n

\n

$121.60<\/p>\n<\/td>\n<\/tr>\n

Greater than $109,000 and less than or equal to $137,000<\/td>\nGreater than $218,000 and less than or equal to $274,000<\/td>\n\n

$81.10<\/p>\n<\/td>\n

\n

$202.70<\/p>\n<\/td>\n<\/tr>\n

Greater than $137,000 and less than or equal to $171,000<\/td>\nGreater than $274,000 and less than or equal to $342,000<\/td>\n\n

$202.70<\/p>\n<\/td>\n

\n

$324.30<\/p>\n<\/td>\n<\/tr>\n

Greater than $171,000 and less than or equal to $205,000<\/td>\nGreater than $342,000 and less than or equal to $410,000<\/td>\n\n

$324.30<\/p>\n<\/td>\n

\n

445.90<\/p>\n<\/td>\n<\/tr>\n

Greater than $205,000 and less than $500,000<\/td>\nGreater than $410,000 and less than $750,000<\/td>\n\n

$445.90<\/p>\n<\/td>\n

\n

$567.50<\/p>\n<\/td>\n<\/tr>\n

Greater than or equal to $500,000<\/td>\nGreater than or equal to $750,000<\/td>\n\n

$486.50<\/p>\n<\/td>\n

\n

$608.10<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:\u00a0<\/p>\n\n\n\n\n\n\n\n\n
\n

Full Part B Coverage<\/strong><\/p>\n<\/th>\n<\/tr>\n<\/thead>\n

Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses with modified adjusted gross income:<\/strong><\/td>\n\n

Income-Related Monthly Adjustment Amount<\/strong><\/p>\n<\/td>\n

\n

Total Monthly Premium Amount<\/strong><\/p>\n<\/td>\n<\/tr>\n

Less than or equal to $109,000<\/td>\n\n

$0.00<\/p>\n<\/td>\n

\n

$202.90<\/p>\n<\/td>\n<\/tr>\n

Greater than $109,000 and less than $391,000\u00a0<\/td>\n\n

$446.30<\/p>\n<\/td>\n

\n

$649.20<\/p>\n<\/td>\n<\/tr>\n

Greater than or equal to $391,000<\/td>\n\n

$487.00<\/p>\n<\/td>\n

\n

$689.90<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:<\/p>\n\n\n\n\n\n\n\n\n
\n

Part B Immunosuppressive Drug Coverage Only<\/strong><\/p>\n<\/th>\n<\/tr>\n<\/thead>\n

Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses with modified adjusted gross income:<\/strong><\/td>\n\n

Income-Related Monthly Adjustment Amount<\/strong><\/p>\n<\/td>\n

\n

Total Monthly Premium Amount<\/strong><\/p>\n<\/td>\n<\/tr>\n

Less than or equal to $109,000<\/td>\n\n

$0.00<\/p>\n<\/td>\n

\n

$121.60<\/p>\n<\/td>\n<\/tr>\n

Greater than $109,000 and less than $391,000\u00a0<\/td>\n\n

$445.90<\/p>\n<\/td>\n

\n

$567.50<\/p>\n<\/td>\n<\/tr>\n

Greater than or equal to $391,000<\/td>\n\n

$486.50<\/p>\n<\/td>\n

\n

$608.10<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n

<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

According to the Social Security Administration (2014b), anyone who is eligible for premium-free part A can enroll in Part B<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-42","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/pages\/42","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=42"}],"version-history":[{"count":13,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/pages\/42\/revisions"}],"predecessor-version":[{"id":25168,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/pages\/42\/revisions\/25168"}],"wp:attachment":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}