Medicare Part B (Medical Insurance)

 

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 Part B helps cover medically necessary services like doctors’ services, outpatient care, and other medical services that Part A doesn’t cover. Part B also covers many preventive services. Part B coverage is your choice. However, you need to have Part B if you want to buy Part A.

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How much does Part B coverage cost?

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You pay the Medicare Part B premium each month. Most people pay the standard Part B premium, which is $202.90 per month in 2026, if they enroll when they are first eligible. The standard premium amount is established annually and may change from year to year. Current premium information is available on Medicare.gov.

Important: In most cases, if you do not enroll in Medicare Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. In addition, you may have to wait to enroll during the General Enrollment Period (January 1 through March 31). If you enroll during the General Enrollment Period, your Part B coverage generally begins on the first day of the month following your enrollment.

 

Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return form, you may pay more.

2026 Medicare Part B Premiums (Including IRMAA)

2024 MAGI (Individual)                          2024 MAGI (Married Filing Jointly)                  Total Part B Premium (2026)

      $109,000 or less$                                                 218,000 or less                                                 $202.90

       $109,001 – $137,000                                           $218,001 – $274,000                                       $284.10

       $137,001 – $171,000                                           $274,001 – $342,000                                       $405.50

       $171,001 – $205,000                                           $342,001 – $410,000                                       $526.90

       $205,001 – $500,000                                           $410,001 – $750,000                                       $648.30

        Over $500,000                                                  Over $750,000                                                    $689.90

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If you have questions about your Part B premium, call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

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General Rule – Employer with Fewer Than 20 Employees with Medicare eligibles:

If an employer has fewer than 20 employees and an employee (or the employee's spouse) is age 65 or older and covered due to current employment, Medicare is generally the primary payer and the employer group health plan is secondary.

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That means if the employee is Medicare-eligible, they generally should enroll in both Part A and Part B. Failing to enroll can result in significant coverage gaps because the employer plan may only pay as though Medicare had paid first.

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Can the Employer Pay the Employee's Medicare Premiums?

Part A

• Most people receive premium-free Part A, so there is nothing for the employer to pay.

• If an employee must buy Part A because they are not entitled to premium-free Part A, an employer could choose to reimburse that premium, but the tax and compliance treatment needs to be evaluated carefully.

Part B

Yes—but this is where employers need to be careful.

An employer may help pay or reimburse an employee's Part B premium, but how it does so is critical.

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Examples:

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• Increasing taxable wages so the employee pays the Part B premium.

• Using a properly structured employer reimbursement arrangement that complies with applicable IRS, ACA, and Medicare Secondary Payer rules.

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Simply paying an employee's Medicare premiums outside a compliant arrangement can create compliance issues.

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Can the Employer Pay for a Medicare Advantage or a Medicare Supplemental Plan?

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Yes,  it should be done correctly.

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An employer may assist with:

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• Medicare Advantage premiums,

• Medicare supplemental Plans

• Part D premiums,

• Medigap premiums,

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Provided the arrangement complies with applicable rules. Employers often do this through:

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• a retiree reimbursement arrangement,

• an employer-sponsored reimbursement arrangement, or

• a properly designed defined-contribution health benefit.

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Important Compliance Issues:

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For active employees with fewer than 20 employees:

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1. Medicare remains primary.

2. The employer plan generally pays secondary.

3. The employer cannot structure benefits in a way that violates Medicare Secondary Payer requirements or other applicable federal laws.

4. The reimbursement method matters from both a tax and employee benefits compliance standpoint.

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Example:

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ABC Company

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• 12 employees

• Employee is age 68 and still working.

The employee enrolls in:

• Medicare Part A

• Medicare Part B

• Medicare Advantage PPO

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The employer could decide to contribute, for example:

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• $250/month toward the employee's Medicare coverage through a compliant reimbursement arrangement.

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The employee uses Medicare Advantage as primary coverage because Medicare is primary for this working-aged individual employed by a company with fewer than 20 employees.

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One Additional Point:

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For Employee benefits broker, it's important to distinguish between what Medicare allows and what the IRS, ACA market reform rules, and employer health plan rules allow. An employer may be able to help pay Medicare premiums, but the arrangement must be structured properly.

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 Can the employer offer a difference plan to the employee under 65

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Yes—but how the employer does it matters.

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For an employer with fewer than 20 employees, the law does not require the employer to offer the exact same group health coverage to employees who are Medicare-eligible as it offers to employees under age 65. Medicare is generally the primary payer for the Medicare-eligible employee.

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Example

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A company has 12 employees:

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• Employees under 65

  • Employer offers a traditional PPO or HMO group health plan.

  • The employer pays 80% of the premium.

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• Employee age 67

  • Medicare is primary.

  • The employer may choose a different approach, such as contributing toward Medicare coverage through a compliant arrangement, rather than keeping that employee on the same group plan.

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However, there are important considerations.

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An employer cannot simply decide:

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• "Everyone over 65 gets Medicare."

• "Everyone under 65 gets the group plan."

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The arrangement must comply with:

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• Medicare Secondary Payer (MSP) rules,

• the Age Discrimination in Employment Act (ADEA),

• IRS rules,

• ACA market reform requirements, and

• ERISA, where applicable.

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From a practical standpoint

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Many small employers do something like this:

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• Employees under 65 remain on the employer group medical plan.

• Employees 65+ enroll in Medicare Parts A and B because Medicare is primary.

• The employer helps pay for Medicare premiums, a Medicare Advantage plan, a Medigap policy, or provides a defined contribution through a compliant reimbursement arrangement.

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That is often large expensive (saving) for the employer/employee while still providing strong coverage for the Medicare-eligible employee.

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This is an area where we can provide significant value. Many employers with fewer than 20 employees are unaware that they may have options to structure benefits differently for Medicare-eligible employees than for younger employees, provided they do so in compliance.

 

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What’s a Part B late enrollment penalty?

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty for as long as you have Part B. The late enrollment penalty takes the standard premium amount and increases it by 10% for each full 12-month period that you could have had Part B, but didn’t. For example, if you were first eligible for Part B in July 2015, but didn’t enroll until January 2018, you’d have a 20% late enrollment penalty.

The standard premium amount would be increased by 20% for as long as you have Part B.

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How can I pay my Part B premium?

If you get Social Security, Railroad Retirement Board (RRB), or Office of Personnel Management (OPM) benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill. If you choose to buy Part A, you’ll always get a bill for your premium. There are 4 ways to pay these bills:

1. Mail your premium payments to:

Medicare Premium Collection Center

P.O. Box 790355

St. Louis, MO 63179-0355

If you get a bill from the RRB, mail your premium payments to: RRB

Medicare Premium Payments

P.O. Box 979024

St. Louis, MO 63197-9000

1. Pay by credit card. To do this, complete the bottom portion of the payment coupon on your Medicare bill and mail it to the address above.

2. Sign up for Medicare Easy Pay, a free service that automatically deducts your premium payments from your savings or checking account each month. Visit Medicare.gov to learn more and to find out how to sign up.

3. Make an online bill payment. Ask your bank if it allows customers to pay bills online. Not all banks offer this service and some may charge a fee. You’ll need to give the bank this information:

   • Account number: your Medicare number without dashes (you’ll find this number on your red, white, and blue Medicare card.)

   • Biller name: CMS Medicare Insurance

   • Remittance address:

Medicare Premium Collection Center

P.O. Box 790355

St. Louis, MO 63179-0355

 

If you have questions about your premiums or need to change your address on your bill, call Social Security at 1-800-772-1213.

TTY users can call 1-800-325-0778. If your bills are from the RRB, call 1-877-772-5772. TTY users can call 1-312-751-4701.

 

Can I get Part B if I don’t have Part A?

If you aren’t eligible for free Part A, you can buy Part B without having to buy Part A, if you’re:

• 65 or older

• A resident of the U.S., and one of these:

—a U.S. citizen

—an immigrant lawfully admitted for permanent residence who has lived in the U.S. without a break for the 5-year period immediately before the month you file for enrollment in Part B

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International Major Medical Travel Insurance Plan

This plan is not Affordable Care Act (ACA) compliant. This plan is not part of Medicare A or B. 

Foreign nationals traveling to the United States on business or for vacation may not be aware of the expensive cost of medical treatment in the US. Imagine the shock and stress that could overwhelm you upon the realization that they are fiscally responsible for medical care in the event of an accident! With International Major Medical plan you can help protect yourself in the event of an accident or illness (see brochure for pre-existing coverage details) while you are traveling in the USA. With our online application, getting coverage couldn’t be easier.

 

Other Uses

1. Foreign Nationals visiting the USA.

2. Foreign Nationals moving to the USA.

3. Foreign Nationals employed by a US company who reside in their home country.

4. Foreign Nationals employed by a US company working outside their home country.

It can be confusing to navigate a foreign country with different customs, restrictions, and guidelines. But, with the International Major Medical Insurance plan, you can travel in the US virtually worry-free. The International Major Medical is specially designed for people visiting the United States on business or vacation. This plan can provide medical coverage for up to one year with benefits up to $1 million.

Options available:

• Accidental Death & Dismemberment up to 10x income

• Kidnap & Ransom coverage

• Hazardous Sports & Activities

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