Essential FAQ Guide to Medicare Part B Deductibles in 2026
- jmegna66
- Dec 26, 2025
- 4 min read
Medicare Part B covers many outpatient services, including doctor visits, preventive care, and medical equipment. Understanding the deductible for Part B is crucial because it affects how much you pay before Medicare starts to share costs. In 2026, changes to the Part B deductible may impact your healthcare budget. This guide answers common questions about Medicare Part B deductibles to help you plan ahead and avoid surprises.
What is the Medicare Part B deductible in 2026?
The Medicare Part B deductible is the amount you pay out of pocket for covered services before Medicare begins to pay its share. For 2026, the deductible has been set at $283. This means you must pay the first $283 of your Part B medical costs yourself each year.
This deductible applies annually, resetting every January 1. Once you meet the deductible, Medicare typically covers 80% of approved costs, leaving you responsible for the remaining 20%.
How does the Part B deductible work?
When you receive a service covered by Part B, such as a doctor's visit or lab test, you pay the full cost until you reach the deductible amount. After paying $283 in 2026, Medicare starts paying its share.
For example, if a doctor visit costs $100 and you have not met your deductible, you pay the full $100. If you have already paid $283 in deductibles earlier in the year, Medicare pays 80% ($80), and you pay 20% ($20).
Does the Part B deductible cover all services?
No, the deductible applies only to Part B services. It does not cover:
Medicare Part A hospital services
Prescription drugs under Part D
Services not covered by Medicare
Some preventive services are covered without requiring you to meet the deductible first. For example, annual wellness visits and certain screenings may be free.
Who has to pay the Part B deductible?
Almost everyone enrolled in Medicare Part B must pay the deductible unless they qualify for assistance programs. People with low income or limited resources may get help through Medicaid or Medicare Savings Programs, which can cover deductibles and coinsurance.
If you have a Medicare Advantage plan, your costs might differ. Some plans waive the Part B deductible or include it in their overall cost structure.
Can the Part B deductible change during the year?
The deductible amount is set annually by the Centers for Medicare & Medicaid Services (CMS) based on healthcare cost trends. It usually changes each January. Once set, it does not change during the year.
How does the Part B deductible affect your monthly premium?
The deductible and premium are separate costs. The Part B premium is a monthly fee you pay to have coverage, while the deductible is the amount you pay for services before Medicare pays.
In 2026, the standard Part B premium is $202.90 per month. You pay this premium regardless of whether you use services or meet the deductible.
What happens if you don’t meet the deductible?
If you do not use any Part B services during the year, you do not pay the deductible. However, you still pay the monthly premium to keep your coverage active.
If you use services but do not reach the deductible, you pay the full cost of those services up to the deductible amount.
Are there exceptions to the Part B deductible?
Yes, some preventive services are covered without requiring you to pay the deductible first. These include:
Annual wellness visits
Certain cancer screenings
Flu shots and vaccines
These services encourage early detection and prevention without upfront costs.
How can you prepare for the Part B deductible in 2026?
Planning ahead can reduce financial surprises. Here are some tips:
Budget for the $283 deductible early in the year.
Use preventive services that do not require deductible payment.
Check if you qualify for assistance programs to reduce costs.
What is the difference between the Part B deductible and coinsurance?
The deductible is the amount you pay before Medicare starts sharing costs. Coinsurance is the percentage you pay after meeting the deductible.
For Part B, after paying the deductible, you usually pay 20% coinsurance for covered services. For example, if a service costs $500, after the deductible, you pay $100 (20%), and Medicare pays $400 (80%).
How does Medigap affect the Part B deductible?
Medigap plans are supplemental insurance policies that help cover out-of-pocket costs like deductibles and coinsurance. Some Medigap plans cover the Part B deductible entirely, meaning you pay nothing out of pocket for the deductible.
If you have a Medigap plan that covers the deductible, you still pay your monthly premiums for both Medicare and Medigap, but your cost-sharing for services decreases.
What if you have a Medicare Advantage plan?
Medicare Advantage plans (Part C) often include Part B coverage but may have different cost structures. Some plans waive the Part B deductible or include it in their copayments.
Check your plan details carefully to understand how deductibles and coinsurance work under your Medicare Advantage plan.
Can you appeal a Part B deductible charge?
If you believe Medicare incorrectly charged you the deductible or if a service should be exempt, you can file an appeal. Keep detailed records and contact Medicare or your plan provider for guidance.
How does the deductible affect high-cost medical care?
If you require frequent medical services, the deductible is just the first step in your out-of-pocket costs. After meeting the deductible, you still pay coinsurance, which can add up.
Consider supplemental coverage or assistance programs if you expect high medical expenses.
What are some common misconceptions about the Part B deductible?
The deductible applies to all Medicare services (it only applies to Part B).
You pay the deductible monthly (it is annual).
Preventive services always require paying the deductible (many do not).
Medicare Advantage plans always require the Part B deductible (some waive it).
Understanding these points helps avoid confusion and unexpected bills.
Where can you find official information about the 2026 Part B deductible?
The Centers for Medicare & Medicaid Services (CMS) website provides official updates on Medicare costs. You can also contact Medicare directly or visit local Social Security offices for assistance.
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