Medicare Part B
Part B is the medical half of Original Medicare. It pays 80% of approved costs — you pay 20%. The catch? That 20% has no cap.
What Medicare Part B Covers
Pretty much everything outside the hospital walls.
Doctor & Specialist Visits
Office visits, second opinions, and most consultations with providers who accept Medicare.
Outpatient Procedures
Same-day surgeries and procedures performed in clinics or outpatient hospital settings.
Lab Work, X-Rays & Imaging
Blood tests, X-rays, MRIs, CT scans, and other diagnostic imaging.
Chemo, Radiation & Injectables
Most cancer treatments delivered on an outpatient basis, plus injectable medications.
Durable Medical Equipment
Wheelchairs, walkers, oxygen, CPAP machines, and other doctor-prescribed equipment.
Ambulance & Emergency Room
Medically necessary ambulance transport and emergency room visits.
Original Medicare’s greatest flaw: the 20% has no CAP — ever.
Medicare pays 80% of approved costs. You pay 20%. On a $100,000 cancer treatment, that's $20,000 out of pocket. On a $500,000 treatment, $100,000. There's no annual stop-loss limit. This is why most seniors pair Part B with a Medicare Supplement or choose Medicare Advantage.
IRMAA — Higher-Income Surcharge (2026)
If your modified adjusted gross income exceeds the thresholds below, Medicare charges a monthly surcharge on top of the standard Part B premium. Rates apply to your 2024 tax return for 2026 coverage.
You can appeal IRMAA
If your income dropped recently (retirement, divorce, death of a spouse, work reduction), file SSA Form SSA-44 — “Life-Changing Event” — with Social Security. This can lower you back to the standard bracket immediately. We help clients identify if they qualify and how to file.
Not sure which plan is right for you?
Book a free 45-minute call with a licensed Medicare specialist. We'll walk through your situation, compare plans side-by-side, and help you choose — with zero pressure.
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