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Analysis using 2026 CMS rates, updated May 2026.
The standard Part B premium is $185.00/month in 2026. Add the annual deductible of $240. If your 2024 income exceeded $106,000 (single) or $212,000 (married), you pay an additional IRMAA surcharge β up to $443.90/month more.
The core tradeoff: Advantage plans typically have lower premiums ($0β$100/mo) but restrict you to a network and cap out-of-pocket costs at $8,300/year in-network. Original Medicare has no OOP cap β which is why Medigap supplemental insurance is essentially mandatory for Original Medicare enrollees.
You have a 6-month open enrollment window starting the month you turn 65 and enroll in Part B. During this window, no insurer can deny you coverage or charge more based on health status. After the window closes, underwriting applies β and pre-existing conditions can mean denial or dramatically higher premiums.
If you're a federal employee or retiree with FEHB coverage, your Medicare decision is more nuanced than for most Americans. The question isn't "FEHB or Medicare" β it's "should I enroll in Part B to make FEHB secondary?"
When Medicare is primary and FEHB is secondary, the coordination typically eliminates most out-of-pocket costs. The annual Part B premium (~$2,220 standard in 2026) is usually recouped within a year through reduced copays and deductibles β especially if you have frequent healthcare needs.
The exception: if you're healthy and your FEHB premiums are already low, the math sometimes doesn't favor Part B enrollment. Run the numbers with your specific FEHB plan's Summary of Benefits.