Episode 3 Block 0 Published
Medicare Part B: What Medical Insurance Actually Covers
Watch on YouTube Medicare Part B covers eighty percent of outpatient costs after a $283 annual deductible, but there is no annual cap on your twenty percent share. This episode breaks down the 2026 Part B premium, the 80/20 cost-sharing rule, free preventive services, and the provider assignment trap that can add up to 15% to your bill. Watch the next video to learn how Medicare Advantage plans work and what trade-offs come with that zero-dollar premium.
▶ Watch next: Medicare Advantage (Part C) Explained: How Plans Work in 2026 https://www.youtube.com/watch?v=7QRWBzEBMoY
📺 Full playlist: Medicare (US - 2026) https://www.youtube.com/playlist?list=PLlIAFxS29648I08akd—o7PeoOBzdOb2S
Chapters
Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and much more — but it comes with a monthly premium everyone must pay, a deductible, and a twenty percent coinsurance with no annual out-of-pocket cap. That last point is the killer: in Original Medicare, there is no maximum out-of-pocket limit, meaning a catastrophic illness can generate unlimited coinsurance. The twenty twenty-six Part B premium is two hundred two dollars and ninety cents per month, and the deductible is two hundred eighty-three dollars.
Key Topics
- The Part B premium in twenty twenty-six: two hundred two dollars and ninety cents per month (deducted from Social Security checks automatically)
- The Part B deductible in twenty twenty-six: two hundred eighty-three dollars per year
- The eighty/twenty cost-sharing rule: Medicare pays eighty percent of the approved amount, you pay twenty percent — with no annual cap
- Free preventive services: the "Welcome to Medicare" visit, Annual Wellness Visits, cancer screenings, flu shots, COVID vaccines, and more — zero dollars if the provider accepts assignment
- Outpatient coverage: doctor visits, lab tests, imaging, mental health, ambulance, durable medical equipment
- The assignment trap: providers who do not accept assignment can charge up to fifteen percent above the Medicare-approved amount (the "limiting charge")
- Why the lack of an out-of-pocket cap is the single biggest reason people buy Medigap or choose Medicare Advantage