What Part B covers
Part B pays for medically necessary care you get outside a hospital stay, and for preventive care. That includes:
- Doctor and other clinician visits, in the office or by telehealth as Medicare allows
- Outpatient hospital services, including emergency room visits and observation stays (see observation status)
- Lab tests, X-rays, MRIs and other imaging
- Durable medical equipment such as walkers, wheelchairs, oxygen and CPAP machines
- Ambulance services when other transport would endanger your health, including air ambulance when medically necessary
- Outpatient mental health care, physical and occupational therapy, and some home health care
- Some drugs given in a doctor's office or clinic, such as infusions and many chemotherapy drugs, and insulin used with a covered pump
Part B doesn't cover most outpatient prescriptions (that's Part D), routine dental care, routine eye exams, hearing aids or long-term custodial care. See does Medicare cover dental?
What Part B costs in 2026
| Cost | 2026 amount |
|---|---|
| Standard monthly premium | $202.90 |
| Yearly deductible | $283 |
| Coinsurance after the deductible | Generally 20% of the Medicare-approved amount |
| Yearly limit on what you pay | None in Original Medicare |
The standard premium went up from $185 in 2025 to $202.90 in 2026, and the deductible from $257 to $283. If you get Social Security, the premium is taken out of your monthly benefit; otherwise Medicare bills you.
Because Original Medicare has no cap on the 20%, many people add a Medigap policy or choose a Medicare Advantage plan, which has a yearly out-of-pocket limit. You still pay the Part B premium with either one.
Higher premiums for higher incomes (IRMAA)
If your modified adjusted gross income from two years earlier was above a set level, you pay an income-related monthly adjustment amount (IRMAA) on top of the standard premium. For 2026, Social Security uses your 2024 tax return. The thresholds start above $109,000 for individuals and $218,000 for married couples filing jointly, and the total Part B premium ranges up to $689.90 a month. A similar surcharge applies to Part D.
The brackets are cliffs: going a dollar over a threshold puts your whole premium in the higher tier. If your income dropped because of a life-changing event such as retirement, the loss of a pension, or a spouse's death, you can ask Social Security to use a more recent year with Form SSA-44. See the full table on Medicare costs in 2026 or try the IRMAA calculator.
Signing up and the late enrollment penalty
You can sign up for Part B during your 7-month Initial Enrollment Period around your 65th birthday. If you or your spouse is still working and covered by that employer's group health plan, you can delay Part B and sign up later during an 8-month Special Enrollment Period that starts when the job or the coverage ends, whichever comes first. See working past 65.
If you miss both, you can sign up during the General Enrollment Period, January 1 to March 31 each year, with coverage starting the month after you sign up. You may also owe a late enrollment penalty: your premium goes up 10% for each full 12-month period you went without Part B when you could have had it, and you generally pay it for as long as you have Part B.
Coverage that doesn't let you delay Part B: retiree coverage, COBRA, a marketplace plan, VA health care and Indian Health Service care don't count as job-based coverage from current work. If you rely on one of these, sign up for Part B when you're first eligible to avoid a penalty and gaps. Arizonans who use IHS or tribal health programs can read tribal nations and IHS; veterans can read veterans and military. To estimate a penalty, use the penalty calculator.
Assignment and excess charges
How much you pay a doctor under Original Medicare depends on the doctor's relationship with Medicare:
Accepts assignment
The doctor agrees to take the Medicare-approved amount as full payment. You pay only the deductible and 20% coinsurance. Most doctors accept assignment.
Doesn't accept assignment
The doctor takes Medicare but can charge you up to 15% more than the Medicare-approved amount. That extra is the excess charge, and you may have to pay the full bill up front and wait for Medicare's share.
Opted out of Medicare
The doctor doesn't bill Medicare at all. You sign a private contract and pay the whole bill yourself; neither Medicare nor a Medigap policy pays.
The 15% cap on excess charges is set by federal law. A handful of states set stricter limits by state law; in Arizona, the federal 15% limit is the one to plan around. Medigap Plan G covers excess charges; Plan N doesn't. With a Medicare Advantage plan, excess charges don't apply in the same way, because you use the plan's network and its cost sharing. To check whether a doctor accepts assignment, use Medicare.gov's care compare tool or ask the office.
Preventive services
Part B covers a range of preventive care, and for many services you pay nothing if your provider accepts assignment:
- A one-time "Welcome to Medicare" preventive visit within the first 12 months you have Part B
- A yearly wellness visit to update your personalized prevention plan
- Screenings for several cancers, diabetes, heart disease and depression, among others
- Flu, pneumococcal, hepatitis B and COVID-19 vaccines (shingles and some other vaccines are covered under Part D)
If your doctor finds and treats a problem during a preventive visit, that part of the visit can have the usual deductible and coinsurance. Arizona summers bring health risks that are worth raising at a wellness visit, such as how medications affect your tolerance to heat; see extreme heat and Medicare.
Help paying for Part B in Arizona
AHCCCS, Arizona's Medicaid program, runs the three Medicare Savings Programs. AHCCCS's eligibility policy sets income limits for them but no resource (asset) limit, so savings and property don't keep you out.
| Program | Income limit (share of federal poverty level) | What it pays |
|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Up to 100% | Part B premium, Part A premium if you owe one, and Medicare deductibles and coinsurance |
| SLMB (Specified Low-Income Medicare Beneficiary) | Above 100% up to 120% | Part B premium |
| QI-1 (Qualifying Individual) | Above 120% up to 135% | Part B premium; limited funding, first come, first served |
For 2026, Medicare.gov lists national monthly income limits of $1,350 (QMB), $1,616 (SLMB) and $1,816 (QI) for an individual. AHCCCS applies its own income-counting rules, so apply even if you're a little over. If you qualify for any of the three, you also automatically qualify for Extra Help with Part D drug costs. Apply online at healthearizonaplus.gov or with AHCCCS's paper application. Use the savings programs calculator to see where you might fall, and read does AHCCCS pay Medicare premiums?
Next steps
For the full list of 2026 amounts, see Medicare costs in 2026. If you're weighing Medigap against Medicare Advantage, a licensed insurance agent with Benefits Life can walk you through plans from the companies they work with, at no cost to you: (602) SENIORS (602-736-4677), TTY 711. Or see plans in your ZIP code.
Sources
- Medicare.gov — What Part B covers
- Medicare.gov — Medicare costs
- Medicare.gov — Avoid late enrollment penalties
- Medicare.gov — Does your provider accept Medicare as full payment?
- Medicare.gov — Preventive and screening services
- Medicare.gov — Medicare Savings Programs
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Social Security Administration — Premiums: rules for higher-income beneficiaries
- AHCCCS Eligibility Policy Manual — 409 Medicare Savings Program
- AHCCCS — Health-e-Arizona Plus
Frequently asked questions
How much is the Part B premium in Arizona in 2026?
The standard Part B premium is $202.90 a month in 2026, the same in every state. People whose 2024 income was above $109,000 (single) or $218,000 (married filing jointly) pay more, up to $689.90 a month. The premium is usually deducted from your Social Security check.
What is the Part B late enrollment penalty?
If you don't sign up for Part B when you're first eligible and don't have job-based coverage from current work, your premium goes up 10% for each full 12-month period you could have had Part B but didn't. You generally pay the penalty for as long as you have Part B.
Can AHCCCS pay my Part B premium?
Yes, if you qualify for a Medicare Savings Program. AHCCCS runs QMB, SLMB and QI-1 for people with income up to 135% of the federal poverty level, and Arizona's eligibility policy doesn't apply a resource limit. Apply at healthearizonaplus.gov or by calling AHCCCS.
What are Part B excess charges?
A doctor who doesn't accept Medicare assignment can charge up to 15% more than the Medicare-approved amount, and you pay that extra. Doctors who accept assignment can't. Ask whether a doctor accepts assignment before you get care.
Are preventive services covered?
Yes. Part B covers a Welcome to Medicare preventive visit in your first 12 months, a yearly wellness visit, and many screenings and vaccines. For many of these you pay nothing if your provider accepts assignment.
