Medicare Part B costs in 2026 add up faster than most beneficiaries expect. Between the monthly premium, the annual deductible, coinsurance, and the possibility of income-based surcharges, your actual out-of-pocket obligation can vary by hundreds of dollars depending on your situation. Understanding how each piece works — and how they interact — is the first step to building a realistic healthcare budget in retirement.
If you’re new to Medicare or approaching 65, here’s a clear breakdown of what Part B will cost you in 2026 and what you can do to manage those costs.
What Medicare Part B Actually Covers
Before diving into the numbers, it helps to know what Part B is. Medicare Part B covers outpatient medical services — the care you receive outside a hospital. That includes:
- Doctor visits and office consultations
- Preventive screenings (mammograms, colonoscopies, annual wellness visits)
- Lab work and diagnostic tests
- Outpatient surgery
- Durable medical equipment (wheelchairs, oxygen, walkers)
- Mental health services (outpatient)
Part B is one half of Original Medicare. The other half, Part A, covers hospital and inpatient care. Together, they form the foundation of your Medicare coverage — but they don’t cover everything, which is where costs can add up.
The Three Core Cost Components
Your Part B costs in 2026 come down to three main pieces: the premium you pay every month, the deductible you pay before Medicare starts sharing costs, and the coinsurance you pay after that.
1. The Monthly Premium: $202.90
The standard monthly premium for Medicare Part B in 2026 is $202.90. This is the amount most beneficiaries pay — up from $185.00 in 2025.
Your premium is typically deducted from your Social Security benefit if you’re already collecting. If you’re not yet drawing Social Security, you’ll receive a bill from Medicare.
The $202.90 applies if your modified adjusted gross income (MAGI) from your most recent tax return is at or below:
- $109,000 for individuals
- $218,000 for married couples filing jointly
If your income is above those thresholds, IRMAA kicks in (more on that below).
2. The Annual Deductible: $283
Before Medicare begins to pay its share of Part B services, you must first meet an annual deductible of $283 — up from $257 in 2025.
This is not a monthly cost; it’s a one-time amount each calendar year. Once you’ve spent $283 on Part B-covered services, Medicare begins paying 80% of the Medicare-approved amount for covered services, and you pay the remaining 20% coinsurance.
The deductible resets every January 1, regardless of where you are in your plan year.
3. Coinsurance: 20% of the Medicare-Approved Amount
After you’ve met your deductible, you’re responsible for 20% coinsurance on most Part B services. This percentage applies to the Medicare-approved amount — not the provider’s full charge.
Here’s a simple example:
- You visit a specialist and the Medicare-approved amount is $200
- You’ve already met your $283 deductible for the year
- You pay 20% of $200 = $40
- Medicare pays the remaining $160
There’s no cap on Part B coinsurance under Original Medicare, which means if you have frequent doctor visits or expensive outpatient procedures, those 20% costs can add up significantly over the course of a year.
How IRMAA Can Change Your Premium
For many beneficiaries, the $202.90 standard premium is the final number. But for higher-income individuals and couples, IRMAA (Income-Related Monthly Adjustment Amount) adds a surcharge on top of the standard premium.
IRMAA is based on your MAGI from two years ago — so your 2024 tax return determines your 2026 IRMAA bracket. Here’s what the surcharges look like for individuals in 2026:
| MAGI Range | IRMAA Surcharge | Total Monthly Part B Premium |
|---|---|---|
| $109,000 or less | $0.00 | $202.90 |
| $109,001 – $137,000 | $81.20 | $284.10 |
| $137,001 – $171,000 | $202.90 | $405.80 |
| $171,001 – $205,000 | $324.60 | $527.50 |
| $205,001 – $499,999 | $446.30 | $649.20 |
| $500,000 or more | $487.00 | $689.90 |
And for married couples filing jointly:
| MAGI Range | IRMAA Surcharge | Total Monthly Part B Premium |
|---|---|---|
| $218,000 or less | $0.00 | $202.90 |
| $218,001 – $274,000 | $81.20 | $284.10 |
| $274,001 – $342,000 | $202.90 | $405.80 |
| $342,001 – $410,000 | $324.60 | $527.50 |
| $410,001 – $749,999 | $446.30 | $649.20 |
| $750,000 or more | $487.00 | $689.90 |
At the highest bracket, a couple could pay a combined $1,379.80 per month for Part B alone — nearly seven times the standard premium.
Common events that can unexpectedly push you into a higher IRMAA bracket include:
- Large 401(k) or IRA distributions
- Roth conversions in a single year
- Capital gains from selling investments or property
- Continued employment income in early retirement
If you’ve experienced a qualifying life event — retirement, divorce, death of a spouse, or reduction in work hours — you can request that Medicare reconsider your bracket by filing Form SSA-44 with the Social Security Administration.
Putting It All Together: Your Actual Part B Cost
Let’s see how these pieces add up in a real scenario.
Example: A single beneficiary earning $65,000 per year
- Monthly premium: $202.90 (no IRMAA)
- Annual premium cost: $202.90 × 12 = $2,434.80
- Annual deductible: $283
- After meeting the deductible, she pays 20% coinsurance on each service
If she visits her primary care doctor, a specialist, gets lab work done, and has one outpatient procedure in a year — and those services total $3,000 in Medicare-approved charges — her coinsurance on those visits would be $600 (20% of $3,000, since the deductible is already met).
Her estimated Part B costs for the year: $3,317.80 before any supplemental coverage.
That’s not a trivial number for someone on a fixed income, and it’s why understanding each piece of the puzzle matters.
What Part B Doesn’t Cover
Part B is an important piece of Medicare, but it has real gaps:
- Routine dental care
- Vision exams and glasses
- Hearing aids
- Prescription drugs (that’s Part D)
- Skilled nursing facility care beyond what Part A covers
- Private-duty nursing
This is where supplemental coverage becomes relevant. A Medicare Supplement (Medigap) plan can help cover the out-of-pocket costs that Original Medicare doesn’t — including the 20% coinsurance after your Part B deductible. Some Medicare Advantage plans also bundle extra benefits like dental, vision, and hearing.
Choosing between Medigap and Medicare Advantage is one of the biggest decisions you’ll make. A comparison of Plan G vs. Plan N — the two most popular Medicare Supplement options — can help you understand what each path looks like in practice.
Planning Ahead: Steps to Take Now
Whether you’re already on Medicare or approaching 65, these steps can help you manage your Part B costs:
-
Review your tax returns. Your MAGI from two years ago determines your IRMAA bracket. Look at your 2024 return to understand where you currently sit.
-
Plan large income events carefully. If you’re considering a Roth conversion, property sale, or other significant distribution, talk to a tax professional about how it might affect your Medicare premiums in future years.
-
Don’t ignore the reassessment process. If you’ve had a qualifying life event, file Form SSA-44. The worst that happens is your request is denied — but many beneficiaries successfully lower their premiums.
-
Consider your full coverage picture. Part B is just one piece. Evaluate whether a Medigap plan or Medicare Advantage plan makes sense for your situation, your budget, and your health needs.
-
Coordinate with Social Security planning. The timing of when you claim Social Security can affect your overall retirement income and, indirectly, your Medicare costs. Understanding how Social Security COLA adjustments affect your actual take-home pay helps you build a more complete retirement budget.
-
Work with an independent advisor. An independent insurance agent can walk you through your options across multiple carriers and plans — not just one company’s products. That means you get a recommendation based on what fits you, not what fits a sales quota.
The Bottom Line
Medicare Part B costs in 2026 are real, and they go beyond the $202.90 monthly premium most people see quoted. Between the $283 deductible, the 20% coinsurance with no annual cap, and the potential for IRMAA surcharges, your actual healthcare spending in retirement depends on your income, your health needs, and the supplemental coverage you choose.
The good news: there are ways to plan for and potentially reduce these costs. But it requires understanding the rules, reviewing your income history, and taking action before the surcharge lands on your bill.
If you’d like to review your options, a licensed agent at Trek Insurance Solutions can walk you through what Medicare Supplement or Medicare Advantage plans are available in your area and help you build a coverage strategy that fits your budget.
For more information, visit us at trekis.net or call 888-960-0442.
Trek Insurance Solutions is a Third-Party Marketing Organization (TPMO). We do not offer every plan available 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 to get information on all of your options.