What is Medicare Part B and what does it cover in 2026?
Medicare Part B is your outpatient medical insurance. It covers doctor visits, preventive care, lab tests, outpatient surgery, durable medical equipment, and mental health services. The standard 2026 Part B premium is $202.90 per month, with an annual deductible of $283. After the deductible, Medicare pays 80% of approved costs and you pay 20% — with no annual cap on that 20%, which is why many people add a Medigap supplement.
What is Medicare Advantage and how is it different from Part B?
Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare offered by private insurers. It replaces Parts A and B and usually includes Part D drug coverage, plus extras like dental, vision, and hearing. Many 2026 plans have $0 monthly premiums, but require you to use a provider network (HMO or PPO). The 2026 federal out-of-pocket maximum is $9,350 in-network — a built-in cost ceiling Original Medicare does not have.
Medicare Advantage vs. Original Medicare: which is better in 2026?
Neither is universally better — it depends on your situation. Original Medicare + Medigap is ideal if you have established specialists or travel frequently, as it covers any Medicare-accepting provider nationwide. Medicare Advantage fits people who want lower upfront costs, bundled drug coverage, and extra benefits like dental and vision, and are comfortable with a provider network. A licensed agent can compare both options side-by-side for your specific doctors and prescriptions.
When do I enroll in Medicare Part B or Medicare Advantage at 65?
Your Initial Enrollment Period (IEP) is a 7-month window: 3 months before your 65th birthday month, the month itself, and 3 months after. To choose a Medicare Advantage plan, you must first be enrolled in Parts A and B. Enrolling in the first 3 months of the IEP ensures your coverage starts on your birthday month. Missing the IEP without qualifying employer coverage triggers a lifetime 10% Part B penalty for each 12-month period you delayed.
Can I switch from Medicare Advantage to Original Medicare?
Yes. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 each year. You can switch to a different Advantage plan or return to Original Medicare during this window. If you return to Original Medicare, your ability to purchase a Medigap plan may be limited depending on your state — guaranteed issue rights typically apply only during your first 6 months on Part B. Timing matters significantly, so consult a licensed agent before switching.
Do Medicare Advantage plans cover prescription drugs in 2026?
Most Medicare Advantage plans include built-in Part D prescription drug coverage. In 2026, the out-of-pocket drug cost cap is $2,100 per year across all Part D plans — a major benefit for people on multiple medications. If you choose Original Medicare, you need a separate Part D plan to avoid a late-enrollment penalty. Drug formularies vary widely, so comparing your specific medications across plans is essential before enrolling.
