By Medicare Health Advisor Publishing Team
Updated: July 11, 2025
If you’re a senior, caregiver, or someone helping your loved ones navigate Medicare, it’s critical to stay informed. Every year, changes are made to Medicare Part B that affect your monthly costs, coverage, and budget. Below is a summary of 2025 Medicare Part B updates you should know—plus a realistic projection for 2026 based on trusted, official sources.
2025 Medicare Part B Premium and Deductible
Starting January 1, 2025, the following changes are in effect:
- Standard Monthly Premium: $185.00
- Annual Deductible: $257
This is a noticeable increase from 2024, when the premium was $174.70 and the deductible was $240. This reflects rising healthcare utilization and inflation in medical service costs.
Source: CMS.gov
If You Have a Higher Income (IRMAA Tiers for 2025)
If your income exceeds certain limits, you’ll pay more for Part B. These are the IRMAA (Income-Related Monthly Adjustment Amounts) for 2025:
- Single filers earning over $106,000
- Married couples filing jointly earning over $212,000
Premiums range from $259.00 up to $628.90 per month, depending on income bracket.
Even if you’re still working part-time or receiving investment income, it could bump you into a higher tier. That’s why it’s always a good idea to review your Social Security income notice and appeal if your income dropped due to retirement or a life-changing event.
2026 Projections: What We’re Likely to See
While 2026 rates haven’t been finalized, trusted analysts from CMS and KFF project the following:
- Standard Part B Premium: ~$195/month (conservative estimate)
- Deductible: ~$270–275/year
- IRMAA thresholds may adjust slightly upward with inflation.
We’ll update this post once official data is released, but for now, these projections should help you start budgeting early—especially if you’re aging into Medicare next year or helping a loved one prepare.
What Does Medicare Part B Cover?
Medicare Part B is the part of Medicare that helps cover medically necessary outpatient services. If you’ve ever been to a doctor’s office, needed lab work, or had an X-ray, chances are it fell under Part B.
Here’s what’s typically covered under Part B:
- Doctor visits (primary care and specialists)
- Lab tests & blood work
- X-rays, MRIs, and diagnostic imaging
- Outpatient surgeries and procedures
- Preventive services (mammograms, colonoscopies, annual wellness visits)
- Vaccines (flu, COVID-19, shingles)
- Durable medical equipment (DME) like walkers, wheelchairs, and oxygen
- Mental health outpatient care
- Some home health services
Think of Part B as the coverage that supports you when you’re not in a hospital, but still need care or monitoring.
Why It’s Important to Have Medicare Part B
Some seniors think they can “skip” Part B to save on premiums—but that’s often a costly mistake.
Here’s why Part B is essential:
- Without Part B, you’ll pay 100% out-of-pocket for common medical services.
- You may incur a lifelong late enrollment penalty if you don’t sign up when first eligible and don’t have other creditable coverage.
- Part B is required if you want to enroll in a Medicare Advantage (Part C) plan.
Even if you’re still working, it’s worth talking to a licensed Medicare broker to understand if you should delay or enroll based on your employer coverage.
Part B Is Required for Medicare Advantage Plans
If you’re planning to join a Medicare Advantage plan, you must have both:
- Part A (Hospital Insurance), and
- Part B (Medical Insurance)
Medicare Advantage (also known as Part C) replaces your Original Medicare coverage with a private plan that includes your Part A and B benefits—often with extras like dental, vision, hearing, gym memberships, and even prepaid cards.
But here’s the catch:
🖐 You can’t join a Medicare Advantage plan unless you’re enrolled in BOTH Parts A and B.
If you’re already getting Social Security, you’ll be automatically enrolled. If not, you’ll need to sign up through SSA.gov or with help from a certified broker.
📝 Final Advice
Whether you’re already on Medicare or getting close to 65, understanding your Part B coverage is key to protecting your health and avoiding high out-of-pocket costs.
If you’re unsure whether to enroll, when to enroll, or how this affects your current insurance, reach out. We can help walk you through your options.
📞 Call now for a free consultation: 347-560-9396
⚠️ Disclaimer:
The information provided in this article is based on publicly available data and my professional experience working in the New York City Metropolitan area. It is for educational purposes only and is not affiliated with or endorsed by Medicare or any government agency. For official information, visit Medicare.gov.
Summary
This 2025 Medicare Part B update explains everything you need to know—from premium increases and coverage basics to IRMAA thresholds, 2026 projections, and why Part B is critical if you’re joining a Medicare Advantage plan. Perfect for seniors, caregivers, and working adults planning ahead.
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