What is Medicare Part B?
Medicare Part B is the medical insurance portion of Original Medicare. It helps cover medically necessary services from doctors and other health care providers, outpatient care, certain home health services, durable medical equipment and many preventive services.
Medicare Part B helps cover a broad range of medical care and services, including:
- Services from doctors and other health care providers
- Outpatient care
- Durable medical equipment
- Certain home health care
- Many preventive services, including screenings, vaccines and yearly Wellness visits
Medicare Part B may also cover services such as outpatient physical, occupational and speech therapy, ambulance services and outpatient mental health care when Medicare requirements are met.
Because coverage can depend on the specific service and circumstances, check Medicare.gov for current coverage information.
How much does Medicare Part B cost?
Most people enrolled in Medicare Part B pay a monthly premium and an annual deductible. Some people pay a higher monthly premium based on their income.
For 2026, the standard Medicare Part B premium is $202.90 per month, and the annual Part B deductible is $283. These amounts can change each year.
Higher-income beneficiaries may also pay an Income-Related Monthly Adjustment Amount (IRMAA) in addition to the standard Part B premium.
Because Medicare premiums, deductibles and income thresholds are updated annually, visit Medicare.gov for the latest Medicare Part B costs.
When should I enroll in Medicare Part B?
When to enroll depends on your individual situation. Three enrollment periods are especially important to understand.
Initial Enrollment Period
For people who become eligible for Medicare at age 65, the Initial Enrollment Period generally lasts seven months. It begins three months before the month you turn 65 and ends three months after the month you turn 65.
General Enrollment Period
If you didn’t enroll in Medicare Part B when you were first eligible and don’t qualify for a Special Enrollment Period, you may be able to sign up during the Medicare Part B General Enrollment Period, which runs from January 1 through March 31 each year.
Don’t confuse this with Medicare Open Enrollment. Medicare Open Enrollment runs from October 15 through December 7 each year and gives people with Medicare an opportunity to make changes to their Medicare Advantage and Medicare drug coverage for the following year.
Special Enrollment Period
You may be able to delay Part B if you have group health coverage based on your or your spouse’s current employment.
If you qualify, you can enroll in Part B while you’re still covered by that group health plan. You can also generally enroll within eight months after employment or employer-provided medical coverage ends, whichever happens first.
Can I delay Medicare Part B if I’m still working?
You may be able to delay Medicare Part B if you or your spouse are still working and you have group health coverage based on that current employment.
Employer size can also affect how Medicare coordinates with employer-sponsored health coverage. According to Social Security Administration, if an employer has fewer than 20 employees, Medicare generally pays first.
If you’re planning to continue working after becoming eligible for Medicare, review your employer coverage carefully before deciding whether to enroll in or delay Part B. Your particular coverage and circumstances matter.
Planning to work past 65? Your current employer coverage can affect how Medicare fits into the picture. Learn more about coordinating Medicare and employer coverage while you continue working.
What if I have COBRA coverage?
COBRA coverage isn’t treated the same way as group health coverage based on current employment for Medicare Part B enrollment.
Social Security Administration specifically states that COBRA doesn’t count as coverage based on current employment for purposes of this Special Enrollment Period. Retiree coverage, Veterans Affairs coverage and individual health coverage also aren’t considered coverage based on current employment for this purpose.
This distinction is particularly important when you’re leaving an employer plan. Don’t assume that enrolling in COBRA gives you the same Part B enrollment protections as active employer coverage.
How do I sign up for Medicare Part B?
The Social Security Administration handles Part B enrollment. If you already have Medicare Part A, you can add Part B during an applicable enrollment period. When you’re ending qualifying employer group health coverage and meet the requirements for a Special Enrollment Period, you can apply for Part B online. Visit SSA.gov for current enrollment options and instructions.
If applying by fax or mail, Social Security identifies two forms that may be needed for a Special Enrollment Period based on employer coverage:
- CMS-40B: Application for Enrollment in Medicare Part B
- CMS-L564: Request for Employment Information
Is Medicare Part B required?
Whether and when to enroll in Part B depends on your circumstances, including whether you have qualifying coverage based on current employment.
People with group health coverage based on current employment may be able to delay Part B and enroll later through a Special Enrollment Period without a lifetime late enrollment penalty.
Because the rules vary depending on your coverage and situation, it’s important to understand your Medicare eligibility and existing health coverage before deciding to delay Part B.
Does Medicare Part B cover an annual physical?
Medicare covers certain preventive services under Part B, but it’s important to understand the distinction between Medicare’s yearly Wellness visit and a routine physical exam. Before scheduling an appointment, review what Medicare covers and what costs may apply.
Medicare Part B decisions can involve more than simply deciding whether to enroll at age 65. Current employment, employer-sponsored coverage, enrollment timing, income and other circumstances can affect your Medicare choices.
M3 Elevate’s Medicare team can help you better understand Medicare coverage and navigate your transition to Medicare. Connect with a M3 Elevate Medicare advisor to learn more about your options.
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Please Note: We do not offer every plan available in your area. Currently we represent 15 organizations which offer 76 products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local state health insurance program to get information on all of your options.
