What Part B covers
Medicare Part B is the medical-insurance half of Original Medicare. For Washington residents, that means coverage for:
- Doctor visits, including primary care and specialists
- Outpatient hospital services and same-day surgeries
- Preventive services such as flu shots, mammograms, colonoscopies, yearly wellness visits and many cancer screenings
- Durable medical equipment (DME) such as wheelchairs, walkers, oxygen and CPAP machines
- Mental health services, including outpatient therapy
- Lab tests and diagnostic imaging
- Ambulance services (when medically necessary)
- Some home health care
- Some drugs given in a doctor's office or clinic, such as chemotherapy and certain injections
What Part B costs in 2026
The 2026 standard Part B premium is $202.90 a month. The yearly deductible is $283. After you meet the deductible, you generally pay 20% of the Medicare-approved amount for most services, and there's no yearly out-of-pocket limit on that 20% under Original Medicare alone.
If you get Social Security or Railroad Retirement benefits, your Part B premium is taken out of your monthly payment. If you don't, Medicare sends you a bill, usually every 3 months, which you can pay online, by mail or by automatic deduction (Medicare Easy Pay).
IRMAA: when higher income means higher premiums
Washington residents with higher incomes pay more for Part B (and Part D) through the Income-Related Monthly Adjustment Amount, or IRMAA. Social Security uses your modified adjusted gross income from your tax return two years earlier, so 2026 premiums are based on 2024 income. The brackets are cliffs: going even slightly over a limit puts you in the next bracket. Washington has no state income tax on wages, but IRMAA is based on your federal return, so it applies here the same way it does everywhere.
| Individual return (2024 income) | Joint return (2024 income) | 2026 Part B premium |
|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 |
| $109,001 – $137,000 | $218,001 – $274,000 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $405.80 |
| $171,001 – $205,000 | $342,001 – $410,000 | $527.50 |
| $205,001 – $499,999 | $410,001 – $749,999 | $649.20 |
| $500,000 or more | $750,000 or more | $689.90 |
Married people who file separate returns and lived with their spouse during the year have different brackets; see IRMAA in Washington. If your income has dropped since the year Social Security used (retirement, loss of pension income, divorce, death of a spouse), you can ask for a new decision with Form SSA-44. More on 2026 costs →
How Washington providers take Medicare
Most providers who see Medicare patients are "participating": they accept Medicare's approved amount as full payment (you pay your share). Some are "non-participating" but still take Medicare patients; they can charge up to 15% above the approved amount, called the "limiting charge." A small number have opted out of Medicare and don't bill it at all; if you see them, you pay the full cost yourself under a private contract.
Before you make a non-emergency appointment, confirm the provider takes Medicare and whether they accept assignment. You can look up doctors and clinics with Medicare's Care Compare tool.
Preventive services: you pay nothing for most
You pay nothing for many preventive services if your provider accepts assignment. They include:
- Yearly wellness visit (a screening and planning visit, not a full physical exam)
- "Welcome to Medicare" preventive visit (once, in your first 12 months with Part B)
- Flu, pneumococcal, hepatitis B and COVID-19 vaccines
- Mammograms, Pap tests, colorectal cancer screenings and prostate cancer blood tests
- Cardiovascular and diabetes screenings
- Counseling to quit tobacco, reduce alcohol misuse, and for depression screening and obesity
- Bone mass measurements
If your doctor finds a problem during a preventive visit and treats it, that part of the visit may have a cost.
Mental health and Part B
Part B covers outpatient mental health services with a provider who accepts Medicare, including individual and group therapy, family counseling and psychiatric evaluations. Since January 2024, licensed marriage and family therapists and licensed mental health counselors can bill Medicare directly, which adds to the providers you can see.
That matters in rural Washington, where mental health providers can be few and far between, and it pairs with telehealth (below). See mental health and Medicare in Washington.
Durable medical equipment
Part B covers medical equipment your doctor orders for use at home, such as:
- Hospital beds, walkers, wheelchairs and scooters
- Oxygen equipment and supplies
- CPAP and BiPAP machines
- Diabetic supplies (test strips, lancets, blood glucose monitors)
- Prosthetic and orthotic devices
You generally pay 20% after the deductible, and the supplier must be enrolled in Medicare. In rural counties, mail-order suppliers are often how equipment arrives; ask whether a supplier accepts assignment.
Telehealth in rural Washington
The Consolidated Appropriations Act, 2026 extended Medicare's telehealth flexibilities through December 31, 2027, so you can have many covered telehealth visits from home wherever you live. Mental health visits by telehealth at home are covered; in-person visit requirements may apply to some of them. For people in the San Juan Islands, the Methow Valley or rural Stevens County, that can save hours of travel. More on telehealth →
What Part B doesn't cover
- Most dental care
- Eye exams for glasses, and glasses or contacts (except after cataract surgery)
- Hearing aids and exams for fitting them
- Long-term custodial care
- Cosmetic surgery
- Acupuncture (except for chronic low back pain)
- Routine foot care
- Care outside the United States (with rare exceptions)
Because of these gaps, some people choose a Medicare Advantage plan, and others buy a Medigap policy plus separate dental or vision coverage. Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. See what Medicare doesn't cover.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov — What Part B covers
- Medicare.gov — Preventive and screening services
- Medicare.gov — Mental health care (outpatient)
- Medicare.gov — Telehealth
- Social Security — Premiums: rules for higher-income beneficiaries
- Social Security — Form SSA-44, Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event
- Medicare.gov — Care Compare
Frequently asked questions
How much is the Part B premium in 2026?
The standard 2026 Part B premium is $202.90 a month. People with higher incomes pay more through IRMAA; in 2026 the highest bracket pays $689.90 a month.
What is the Part B deductible for 2026?
The 2026 Part B deductible is $283 a year. After you meet it, you generally pay 20% of the Medicare-approved amount for most services, with no yearly limit under Original Medicare alone.
Does Part B cover dental and vision?
Generally no. Original Medicare doesn't cover routine dental care, eye exams for glasses, or hearing aids. Some Medicare Advantage plans offer these as extra benefits, which vary by plan and county, or you can buy separate dental and vision coverage.
Can a drop in income lower my IRMAA?
Yes. If you've had a life-changing event such as retirement, the death of a spouse, divorce or the loss of pension income, you can ask Social Security to use a more recent year's income by filing Form SSA-44 with proof of the event.
Does Medicare cover telehealth in Washington?
Yes. Under a 2026 federal law, Medicare can pay for many telehealth visits from your home, anywhere in the country, through December 31, 2027. Mental health visits by telehealth are covered at home, though in-person visit rules may apply. That matters for island and rural communities in Washington.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
