If Medicare Part A is the "hospital" side of Original Medicare, Part B is the "medical" or "outpatient" side. For most people turning 65 in Charlotte and across North Carolina, Part B is the part of Medicare you'll use the most day to day — it's what pays when you see your doctor, get a lab test, or need equipment at home. Here's a clear, honest look at what Part B covers, what it costs in 2026, and where its limits are.

What Medicare Part B covers

Part B (Medical Insurance) focuses on the care you get without being formally admitted to a hospital. Its main categories include:

  • Doctor visits and outpatient care — physician services, specialist visits, outpatient hospital care, and mental health services.
  • Preventive services — many at no cost to you when you use a Medicare-approved provider who accepts assignment. This includes the annual "Wellness" visit, many vaccines, and a range of covered screenings.
  • Durable medical equipment (DME) — medically necessary equipment your doctor prescribes for use at home, such as wheelchairs, walkers, hospital beds, oxygen equipment, and blood-sugar monitors.
  • Lab tests, outpatient surgery, ambulance services, and outpatient physical, occupational, and speech therapy.
  • Some home health care — the skilled, part-time or intermittent portion (skilled nursing and physical, occupational, or speech therapy) when a doctor certifies you're homebound and orders it. Part A and Part B share this home health benefit.

A common trap worth knowing

If you're kept in a hospital "under observation" rather than formally admitted as an inpatient, that care is billed as outpatient under Part B — not under Part A. It's always worth asking about your admission status while you're in the hospital, because it can change how your care is paid for.

What Medicare Part B costs in 2026

Part B has a monthly premium and cost-sharing you should plan for:

  • Standard monthly premium (2026): $202.90. Higher earners may pay more (see below).
  • Annual deductible (2026): $283. You pay this before Part B starts sharing costs.
  • Coinsurance: After the deductible, you generally pay 20% of the Medicare-approved amount for most Part B services.

An important honest point: Original Medicare has no annual out-of-pocket cap on Parts A and B. That 20% coinsurance keeps going with no ceiling. This is one of the main reasons many people in North Carolina pair Original Medicare with a Medicare Supplement (Medigap) policy, or choose a Medicare Advantage plan, which is required to have a yearly out-of-pocket maximum. Which route fits you depends on your budget, your doctors, and how much cost predictability you want — there is no single "best" answer for everyone.

Higher-income premiums (IRMAA)

If your income is above certain levels, you pay a higher-income add-on called IRMAA on top of the standard premium. In 2026, IRMAA begins above a MAGI (modified adjusted gross income) of $109,000 for an individual or $218,000 for a married couple filing jointly. The first bracket adds $284.10 to your Part B premium (and $14.50 to Part D). Medicare uses your MAGI from two years prior, so 2026 IRMAA is based on your 2024 income. If your income has dropped since then — for example, because you retired — you can ask Social Security to reconsider based on a life-changing event.

When you sign up for Part B

Your Initial Enrollment Period is the 7-month window around your 65th birthday — the 3 months before your birth month, your birth month, and the 3 months after. If you're already receiving Social Security at least 4 months before you turn 65, you're enrolled in Part A and Part B automatically. If you're not yet drawing Social Security — for instance, because you're still working — you must sign up yourself through Social Security.

Signing up on time matters. The Part B late-enrollment penalty is 10% of the premium for each full 12 months you could have had Part B but didn't — and that penalty generally lasts for life. If you missed your window, the General Enrollment Period runs January 1 through March 31 each year. (If you're still working and covered by an employer group plan, you may qualify to delay Part B without penalty — a good thing to confirm before you make a decision.)

What Part B does NOT cover

Part B is broad, but it leaves real gaps. Original Medicare (Parts A and B) generally does not cover:

  • Routine dental care — cleanings, fillings, dentures, and most dental work.
  • Routine vision — eye exams for glasses or contacts, and the glasses or contacts themselves. (Medicare does cover some medical eye care, such as cataract surgery.)
  • Hearing — routine hearing exams and hearing aids.
  • Most prescription drugs you take at home — that's the gap Part D fills.
  • Long-term custodial care — ongoing help with daily-living activities when that's the only care needed.
  • Most care outside the United States.

Many Medicare Advantage (Part C) plans offer some of these — routine dental, vision, or hearing — as extra benefits, though the specifics vary widely by plan, carrier, and location and are not guaranteed. People who stay with Original Medicare sometimes add a separate dental, vision, and hearing policy instead. This is a genuinely individual decision, and a good one to review each year.

Part B and travel

Because Original Medicare isn't network-based, Part B travels with you anywhere in the U.S. — you can see any provider who accepts Medicare. That's helpful for North Carolina snowbirds who spend winters elsewhere. Outside the U.S., though, Part B generally does not pay except in a few narrow emergency situations, which is why some travelers add a Medigap plan with a foreign travel emergency benefit or a separate travel-medical policy.

How The Jordan Insurance Agency helps

Understanding what Part B covers is only the first step — the harder question is what to pair it with. The Jordan Insurance Agency is an experienced, full-time, licensed and certified independent agency based in Charlotte, North Carolina, serving people across the state who are approaching 65. Because we're independent, we represent multiple carriers rather than pushing one company's product, and we walk you through how a Medicare Supplement (Medigap) plan or a Medicare Advantage plan would fill in that 20% coinsurance and the dental, vision, hearing, and drug gaps Part B leaves behind.

We complete our AHIP and carrier certifications every year, carry E&O coverage, and review your plan at every renewal — because premiums, formularies, and plan extras change, and so do your needs. Best of all, our help costs you nothing extra: the carrier pays the agent, and your premium is the same whether you enroll on your own or with us. If you'd like an honest, plain-English review of how Part B fits into your overall coverage, we're glad to sit down with you. For the current year's exact figures, you can also check Medicare.gov or call 1-800-MEDICARE.

Plan availability & disclaimer

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. The Jordan Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program.