What does Part B cover?
Part B covers two kinds of services: medically necessary services to diagnose or treat a condition, and preventive services to catch problems early.
- Doctors and other clinicians: office visits, specialists, surgeons, and doctors' services during a hospital stay.
- Outpatient care: emergency room visits, outpatient surgery, observation stays, lab tests, X-rays and imaging.
- Preventive services: the Welcome to Medicare visit, yearly wellness visits, many cancer screenings, flu, COVID-19, pneumonia and hepatitis B shots, and more. Many cost you nothing if your provider accepts assignment.
- Durable medical equipment: walkers, wheelchairs, hospital beds, oxygen and diabetes testing supplies. If equipment Medicare paid for is lost or damaged in a hurricane, Medicare usually covers repair or replacement from a Medicare-approved supplier.
- Ambulance rides when other transportation could endanger your health, including air ambulance when ground transport can't get you to care in time.
- Outpatient mental health care, including from licensed clinical social workers, marriage and family therapists and mental health counselors. Through December 31, 2027, Medicare covers telehealth services you get anywhere in the U.S., including at home.
- Physical, occupational and speech therapy.
- Some drugs given in a doctor's office or clinic, such as many injections and infusions, and insulin used with a pump, which costs no more than $35 for a month's supply.
Part B doesn't cover routine dental care, hearing aids, routine eye exams for glasses, or most prescription drugs you fill at a pharmacy; those go to Part D. See Medicare basics.
What does Part B cost in 2026?
| Cost | 2026 amount |
|---|---|
| Standard monthly premium | $202.90 |
| Yearly deductible | $283 |
| Coinsurance after the deductible | Usually 20% of the Medicare-approved amount |
| Premium with income above $109,000 (single) or $218,000 (joint) | From $284.10 a month (IRMAA) |
Original Medicare has no yearly limit on the 20% you pay. That's why many people add a Medigap policy or choose a Medicare Advantage plan, which has a yearly out-of-pocket limit. IRMAA uses your modified adjusted gross income from 2 years earlier (your 2024 federal tax return for 2026). Florida has no state income tax, but IRMAA uses federal income, so a large gain the year you sell a home up north before moving here can raise your premium two years later; see does selling a home raise IRMAA? and the IRMAA calculator. CMS announces the 2027 Part B amounts in the fall; see Medicare costs in 2027.
What does "accepts assignment" mean in Florida?
A provider who accepts assignment agrees to take the Medicare-approved amount as full payment. You pay only your deductible and 20% coinsurance. Providers who participate in Medicare but don't accept assignment on a claim can charge up to 15% more (the limiting charge). Florida adds its own protections in s. 456.056, Florida Statutes:
- Doctors must accept Medicare assignment for treatment of an emergency medical condition.
- For non-emergency care, if your primary doctor accepts assignment, the consulting doctors must too, unless you agree in writing before treatment that they need not.
Some clinicians opt out of Medicare entirely; then Medicare pays nothing for their services, except in emergencies. CMS's opt-out list shows about 2,900 Florida clinicians as of September 2026, so check before you book. Doctors who charge a concierge membership fee must still follow Medicare's rules, and Medicare doesn't cover the fee. See finding doctors who accept Medicare in Florida.
When should I sign up for Part B?
Most people sign up during their 7-month Initial Enrollment Period around 65. If you already get Social Security, you're enrolled automatically and can decline Part B by following the card's instructions. If you or your spouse are still working with job-based coverage at an employer with 20 or more employees, you can usually delay Part B and sign up later in a special enrollment period, which ends 8 months after the job or the coverage ends, with forms CMS-40B and CMS-L564. See working past 65.
Late penalty: if you go without Part B when you could have had it and you didn't have job-based coverage from current work, your premium goes up 10% for each full 12-month period you waited, usually for as long as you have Part B. If you miss your window, the General Enrollment Period runs January 1 to March 31, and coverage starts the month after you sign up. Estimate it with the late enrollment penalty calculator.
COBRA, retiree coverage such as State Group Insurance retiree coverage, and VA health care don't count as coverage from current work, so they don't let you delay Part B without a penalty.
How do I pay the Part B premium?
If you get Social Security or Railroad Retirement benefits, the premium comes out of your monthly payment. Most Florida public jobs are covered by Social Security (88.5% of state and local government workers in 2023, according to the Congressional Research Service), so most retired Florida teachers and public workers who collect Social Security pay this way too. If you don't get those benefits yet, Medicare bills you every 3 months, or every month if you also owe a Part A premium or a Part D IRMAA. You can pay online through your Medicare account, set up Medicare Easy Pay to have it deducted from your bank account, use your bank's online bill pay, or mail a payment. Pay on time: unpaid premiums can end your Part B coverage.
Florida retirees, military families and Part B
- State Group Insurance retirees: the State says that if you're eligible for Medicare, its plan pays claims secondary to Medicare even if you don't buy Part B, so you'd pay the portion (about 80%) Medicare would have paid. The same applies to Medicare-eligible dependents. The State's group Medicare Advantage (MA-PD) plans require Part A and Part B. See do Florida state retirees need Part B?
- FRS Health Insurance Subsidy: Florida Retirement System retirees can get a monthly payment toward health insurance costs, based on years of service, once their coverage is certified. You don't have to be in the State's plan to get it (s. 112.363). See the FRS Health Insurance Subsidy and Medicare.
- Local government retirees: Florida law lets retirees of counties, cities and school districts stay in their former employer's group plan (s. 112.0801). Ask how that plan works with Part B before you turn 65.
- Military retirees near MacDill, Eglin, Jacksonville, Pensacola and Florida's other bases: TRICARE For Life requires both Part A and Part B, and you pay the Part B premium. See military, veterans and TRICARE in Florida.
Help paying Part B in Florida
Florida's Medicare Savings Programs are run by the Department of Children and Families (DCF). Income limits are set as a share of the federal poverty level (DCF Appendix A-9.1), and assets can't exceed $9,950 (single) or $14,910 (couple):
- QMB (income up to 100% of the poverty level): pays Medicare premiums, deductibles and coinsurance.
- SLMB (over 100% up to 120%) and QI-1 (over 120% up to 135%): pay the Part B premium. QI-1 depends on a yearly federal allocation.
Anyone approved also gets Extra Help with Part D automatically. Apply online through ACCESS Florida or call DCF's customer call center at (850) 300-4323 (Florida Relay 711). See Medicare Savings Programs in Florida and the savings programs screener.
Next steps
Sign up for Part B through Social Security at ssa.gov or 1-800-772-1213 (TTY 1-800-325-0778). To review how Medigap or Medicare Advantage would work alongside Part B with plans from the companies they work with, you can request a call from a licensed insurance agent. For other questions, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).
Sources
- Medicare.gov — What Part B covers
- Medicare.gov — Preventive and screening services
- Medicare.gov — Telehealth
- Medicare.gov — Getting care in a disaster or emergency
- CMS — 2026 Medicare Parts A and B premiums and deductibles
- Medicare.gov — Avoid late enrollment penalties
- Medicare.gov — Pay your premiums
- Medicare.gov — When does Medicare coverage start?
- Florida Statutes — s. 456.056, Treatment of Medicare beneficiaries
- CMS — Opt Out Affidavits (September 2026)
- Medicare.gov — Concierge care
- MyBenefits (Department of Management Services) — Retirees FAQ
- Florida Statutes — s. 112.363, Retiree health insurance subsidy
- Florida Statutes — s. 112.0801, Group insurance; participation by retired employees
- Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961), Table 1
- TRICARE — TRICARE For Life
- DCF ESS Program Policy Manual — 2040.0817 to 2040.0819, QMB, SLMB and QI1 (PDF)
- DCF — Appendix A-9.1, Medicare Savings Programs and LIS financial standards, April 2026 (PDF)
- DCF — Public Assistance (ACCESS Florida)
Frequently asked questions
How much is Medicare Part B in 2026?
The standard Part B premium is $202.90 a month and the deductible is $283 for the year. People with higher incomes pay more through IRMAA, starting above $109,000 of income for a single filer or $218,000 for a joint return, based on the tax return from 2 years earlier.
Do Florida state retirees need Part B?
It's strongly in your interest. If you keep State Group Insurance after you become eligible for Medicare, the State plan pays as if you had Part B, whether or not you do, so without Part B you'd pay the share Medicare would have paid, roughly 80% of Part B services. The State's group Medicare Advantage plans require Part B.
Do Florida doctors have to accept Medicare's approved amount?
Not always, but Florida law (s. 456.056) requires doctors to accept Medicare assignment for emergency care. For non-emergency care, if your main doctor accepts assignment, the specialists they consult must too, unless you agree otherwise in writing first. Elsewhere, federal limits on extra charges apply.
What is the Part B late enrollment penalty?
Your monthly premium goes up 10% for each full 12-month period you could have had Part B but didn't, and you usually pay it as long as you have Part B. If you qualified for a special enrollment period because of job-based coverage from current work, there's no penalty.
Can Florida help pay my Part B premium?
Yes, if your income and assets are limited. Florida's Medicare Savings Programs, run by the Department of Children and Families, pay the Part B premium for people with income up to about 135% of the federal poverty level, and QMB also pays Medicare deductibles and coinsurance. Apply through ACCESS Florida.
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