Medicare Part B

Medicare Part B is your medical insurance. It covers two main categories of services: medically necessary services — doctor visits, outpatient care, lab tests, X-rays, ambulance services, durable medical equipment (DME), and mental health services; and preventive services — annual wellness visits, flu shots, cancer screenings, and other preventive care, often at no cost to you. Part B does not cover prescription drugs (that's Part D), routine dental, vision, hearing, or cosmetic procedures. A Medicare Supplement plan can help cover what Part B leaves behind.

In 2026, the standard monthly Part B premium is $202.90 — an increase of $17.90 from $185.00 in 2025. The annual deductible is $283 (up from $257 in 2025). After meeting the deductible, Medicare pays 80% of approved costs and you pay the remaining 20% coinsurance with no annual out-of-pocket cap under Original Medicare alone. High-income earners pay more through IRMAA surcharges. A Medicare Supplement plan can cover most or all of that 20%, protecting you from unexpected large bills.

No, Part B is voluntary — but most people should enroll when first eligible. Here's what to know:

• No other coverage — enroll at 65 to avoid the late enrollment penalty.
• Active employer coverage — if you or your spouse are still working and covered by a group health plan, you may delay Part B penalty-free until that coverage ends.
• Retiree or COBRA coverage — these do not qualify to delay Part B; enroll at 65.
• Medicaid — your state may automatically pay your Part B premium.

Not sure what applies to you? Call Brad at (920) 251-4969 for a free no-obligation review.

If you delay enrolling in Part B without qualifying coverage (such as active employer insurance), you will face a permanent late enrollment penalty. Your monthly premium increases by 10% for each full 12-month period you went without Part B. For example, if you delayed 2 years, your premium is permanently 20% higher for as long as you have Part B. This makes enrolling on time — or understanding exactly when you can delay — critically important. Brad can help you avoid this penalty entirely.

IRMAA stands for Income-Related Monthly Adjustment Amount. If your modified adjusted gross income (MAGI) exceeds certain thresholds, you pay a surcharge on top of the standard $202.90 Part B premium. In 2026, IRMAA applies to individuals earning over $106,000 (or couples over $212,000). Surcharges are based on your income tax return from two years prior — so your 2026 premium is based on 2024 income. If your income has dropped significantly since then (due to retirement, for example), you can appeal the IRMAA determination with Social Security.

Yes. Medicare Part B covers many preventive services at $0 cost to you — meaning no deductible or coinsurance — when provided by a Medicare-participating provider. These include: your annual wellness visit, cardiovascular screenings, colorectal cancer screenings, mammograms, flu and pneumonia shots, diabetes screenings, depression screenings, and more. It's one of the most overlooked benefits of Part B. Brad can help you understand which screenings you're entitled to and make sure your plan maximizes this coverage.

Doctors who accept Medicare assignment agree to charge only Medicare-approved rates, meaning you pay just 20% after your deductible. Doctors who do not accept assignment may charge up to 15% more than the Medicare-approved amount — a "limiting charge" — which you would pay out of pocket. To avoid surprise bills, always confirm your doctor accepts Medicare assignment before your visit. Most Wisconsin providers do accept assignment, and Brad can help you find plans and providers that keep your costs predictable.

Yes — and this is one of the most powerful reasons to consider a Medicare Supplement (Medigap) plan. Depending on the plan you choose, a Supplement can cover your Part B deductible ($283 in 2026), your 20% coinsurance, and even excess charges from doctors who don't accept assignment. Since Original Medicare has no annual out-of-pocket cap, a Supplement gives you financial predictability. Brad shops multiple top carriers to find you the best Supplement plan at the lowest premium. Learn more about Medicare Supplement plans →

Yes and no. Medicare Advantage (Part C) plans include all Part A and Part B benefits — but they are administered by a private insurance company rather than the federal government. You must remain enrolled in Part B and continue paying your Part B premium ($202.90/month in 2026) even with a Medicare Advantage plan. In return, the Advantage plan may offer additional benefits like dental, vision, hearing, and fitness coverage, and often has lower or $0 plan premiums. Brad can compare Advantage vs. Original Medicare + Supplement options side by side for your specific situation.