Medicare Part B in Oregon

Medicare Part B is the medical half of Original Medicare. It covers doctor visits, outpatient hospital services, durable medical equipment, preventive care, ambulance, and most physical and mental health care you get outside a hospital stay. Almost everyone with Medicare pays a Part B premium, and for most people it is their largest regular Medicare cost. You also pay the Part B premium if you join a Medicare Advantage plan.

2026 Part B costs

Because Original Medicare has no yearly limit, many people add a Medigap policy or choose a Medicare Advantage plan, which has a yearly limit on in-network costs. CMS publishes the 2027 Part B premium and deductible each fall; see Medicare costs in 2027.

What Part B covers

Doctor and outpatient services

• Visits with primary care doctors, specialists, nurse practitioners and physician assistants
• Outpatient hospital services, including observation stays, outpatient surgery, and emergency room visits that don't lead to an inpatient admission
• Doctors' services while you're a hospital inpatient
• Outpatient physical, occupational and speech therapy when medically necessary (no yearly cap)
• Lab tests, X-rays, imaging and other diagnostic tests
• Telehealth visits covered under Medicare's rules

Preventive services

Many preventive services cost nothing when your provider accepts assignment, including:

• The Welcome to Medicare preventive visit and a yearly wellness visit
• Screenings for heart disease, diabetes and depression
• Many cancer screenings: mammograms, cervical, colorectal, prostate and lung
• Shots for flu, pneumonia, COVID-19 and hepatitis B (for people at medium or high risk); the shingles vaccine is covered by Part D
• Bone density tests and glaucoma tests for people at high risk

Durable medical equipment and ambulance

Durable medical equipment (DME) includes wheelchairs, hospital beds, walkers, oxygen equipment, CPAP machines, blood sugar monitors and prosthetics. The supplier must be enrolled in Medicare. Ambulance service is covered when any other way of getting there could endanger your health.

Mental health and substance use care

Part B covers outpatient counseling and therapy, psychiatric evaluation, medication management, and partial hospitalization and intensive outpatient programs. Since 2024, Medicare also pays licensed marriage and family therapists and licensed mental health counselors, which widens the choice of providers in rural Oregon. See does Medicare cover mental health in Oregon?

Some prescription drugs

Part B covers drugs you usually don't give yourself, such as many infusions and injections given in a doctor's office or clinic, plus some oral cancer drugs, drugs used with DME, and certain vaccines. Insulin used with a Part B-covered insulin pump costs no more than $35 for a month's supply, and the Part B deductible doesn't apply to it. Most pharmacy prescriptions are covered by Part D instead.

What Part B doesn't cover

• Routine dental care, eye exams for glasses, and hearing aids
• Long-term custodial care in assisted living, memory care or a nursing home
• Most cosmetic surgery
• Acupuncture, except for chronic low back pain (up to 12 visits in 90 days, and up to 20 a year when you're improving)
• Routine foot care, except for some conditions such as diabetic nerve damage
• Care outside the U.S., except in rare cases

Medicare Advantage plans may offer extra benefits 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.

IRMAA: the income-related monthly adjustment amount

If your modified adjusted gross income (MAGI) is above $109,000 (single) or $218,000 (married filing jointly), you pay the standard premium plus an income-related amount. Social Security uses your tax return from two years earlier: your 2026 premium is based on your 2024 MAGI.

Married people who live with their spouse and file separately have their own brackets; see Medicare costs in Oregon or the IRMAA bracket finder.

Assignment and excess charges

A doctor who accepts assignment agrees to take the Medicare-approved amount as full payment. A doctor who is enrolled in Medicare but doesn't accept assignment can charge up to 15% more than the Medicare-approved amount, called an excess charge, and you pay the difference. Ask before your visit. Medigap Plan G pays excess charges; Plan N doesn't. Some providers opt out of Medicare entirely; Medicare pays nothing for their services, and they must have you sign a private contract first.

Help paying Part B in Oregon

If your income is limited, a Medicare Savings Program can pay your Part B premium, and the Qualified Medicare Beneficiary program also pays Part A and B deductibles and coinsurance. Oregon has no asset limit for these programs (Oregon Department of Human Services), so only income counts. You can apply at benefits.oregon.gov or through the ONE Customer Service Center at 1-800-699-9075 (TTY 711). See Medicare Savings Programs in Oregon and the Oregon Health Plan and Medicare.

Federally qualified health centers and rural health clinics around Oregon accept Medicare, and many tribal clinics bill Medicare too; see rural Oregon and Medicare and tribal health and Medicare.

When to enroll in Part B

• Initial Enrollment Period: the 7 months that start 3 months before the month you turn 65. Sign up before your birthday month for coverage to start that month.
• Special Enrollment Period: if you or your spouse are still working with job-based group coverage, you can sign up while you have it or during the 8 months after the job or the coverage ends, whichever comes first. COBRA and retiree coverage don't count as current work. See the Part B Special Enrollment Period.
• General Enrollment Period: January 1 to March 31 each year if you missed your other chances. Coverage starts the month after you sign up, and a late penalty may apply.

The Part B late penalty adds 10% of the standard premium for each full 12 months you went without Part B when you could have had it, and it usually lasts as long as you have Part B. Still working at 65? Read working past 65 in Oregon.

Related guides

• Medicare Part A in Oregon
• Medigap in Oregon
• What is IRMAA and will I pay it?
• How much is Medicare Part B in 2027?

To compare how Medigap or Medicare Advantage would work with your doctors, you can request a call from a licensed insurance agent.

Sources

• CMS — 2026 Medicare Parts A & B premiums and deductibles (including IRMAA)
• Medicare.gov — Medicare costs
• Medicare.gov — Avoid late enrollment penalties
• Medicare.gov — Preventive and screening services
• Medicare.gov — Mental health care (outpatient)
• Medicare.gov — Acupuncture
• Medicare.gov — Prescription drugs (outpatient) under Part B
• Medicare.gov — Does your provider accept Medicare as full payment?
• Social Security Administration — Form SSA-44, Medicare income-related monthly adjustment amount: life-changing event
• Medicare.gov — Care Compare
• Oregon Department of Human Services — Medicare Savings Programs

Frequently asked questions

Medicare in your Oregon county

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