Medicare Part B


Original Medicare coverage is made up of two parts. Medicare Part B provides outpatient coverage for various medical services and doctor appointments. Medicare Part B coverage is available for preventive and medically necessary care.

What Does Medicare Part B Cover?

Medicare Part B offers comprehensive coverage for outpatient services, durable medical equipment, and doctor visits. There are two main types of coverage under Medicare Part B: medically necessary services and preventative services.

Medicare Part B Coverage

Medically necessary Medicare Part B coverage encompasses a variety of tests, procedures, and care options. To be considered medically necessary, the medical service or supply must be required to treat or diagnose a medical condition. Each situation is different, so a medical supply or service that is deemed medically necessary for one person may not be medically necessary for another.

It is easy to keep up with your general health needs through Medicare Part B by utilizing annual wellness visits. The preventive care Medicare Part B coverage provides includes vaccines, annual cancer screenings, lab work, mental health counseling, and more. At your annual wellness visit, you can receive many of these preventive services.

Alongside coverage for preventive care services, Medicare Part B also covers certain outpatient services you receive in the hospital. These include surgeries, diagnostic imaging, chemotherapy, and dialysis. If you are administered drugs while at the hospital, Medicare Part B will provide coverage for those as well.

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What is Not Covered by Medicare Part B?

Medicare Part B does not provide dental, vision, hearing, or prescription drug coverage benefits. Medicare Part B also does not cover anything not considered medically necessary or preventive, or any medical services provided by non-Medicare-participating providers. Finally, inpatient services receive coverage under Part A of Medicare, not Medicare Part B.

Medicare Part B Costs

When you enroll in Medicare Part B you are responsible for the Medicare Part B premium. In 2022, the standard Medicare Part B premium is $170.10 each month. However, those in a higher income bracket will pay a higher monthly premium.

For most beneficiaries, the Medicare Part B premium amount is automatically subtracted from their monthly Social Security benefits check. If you do not receive Social Security, you will receive a quarterly bill from Medicare. To pay, Medicare offers an online payment option called Easy Pay, which you can access with a MyMedicare account. Additionally, you may pay your quarterly premium by mail instead.

Alongside the premium, Medicare Part B includes an annual deductible and 20% coinsurance for which you are responsible to pay out-of-pocket. In 2022, the Medicare Part B deductible is $233. Once you meet the annual deductible, Medicare will cover 80% of your Medicare Part B expenses.

Medicare Part B Coverage Chart

Reduced Medicare Part B Premium

If you are a lower-income beneficiary and are dual-eligible for both Medicare and Medicaid, you may be eligible for a Medicare Savings Program that will pay all or most of your Medicare Part B premium. Also, certain Medicare Advantage plans will reduce the cost of your Medicare Part B monthly premium through a give back program for policyholders.

Enrolling In Medicare Part B

Beneficiaries collecting Social Security benefits when they age into Medicare at 65 will automatically enroll in Medicare Part B. If this is the case for you, you will receive your Medicare card one to three months before your 65th birthday. If you are not collecting Social Security benefits, you will need to enroll yourself. You can apply for Medicare online, over the phone, or in person.

All beneficiaries will have an Initial Enrollment Period for Medicare Part B. Your Initial Enrollment Period begins three months before your 65th birth month and ends three months after you turn 65. If you do not enroll during your Initial Enrollment Period and do not have creditable coverage, you could be subject to a penalty when you decide to enroll in Medicare Part B in the future.

FAQs

How long does it take to get Medicare Part B after applying?
Approval for Medicare Part B can take up to 30-60 days if you’re applying outside your Initial Enrollment Period and not automatically enrolled in Medicare.
Am I required to pay the Medicare Part B deductible upfront?
No, your doctor will need to bill Medicare first. Then, Medicare will bill you for the deductible.
Do you pay the Medicare Part B premium with Medicare Advantage?
Yes, you must pay the Medicare Part B premium when you enroll in a Medicare Advantage Plan.
Do I have to pay for Medicare Part B if I have other insurance?
Depending on the insurance you have, you may be able to delay Medicare Part B without penalty.
Does Medicare Part B cover glasses?
No, Medicare Part B will not cover the cost of glasses. Some Medicare Advantage plans may provide some benefits for glasses, as will ancillary plans that pair with Original Medicare.
Can I add Medicare Part B at any time?
It is not possible to enroll in Medicare Part B at any time. There are two enrollment windows when you can enroll in Medicare Part B, unless you have a special circumstance. The first opportunity to enroll is during your Initial Enrollment Period and the second opportunity is during the annual General Enrollment Period.
Is Medicare Part B eligibility based on income?
No, eligibility for Medicare Part B is not based on income. It’s based on your age or disability status.

How to Get Help with Medicare Part B

We understand the different Medicare parts and plan letters can become confusing. However, the Medicare alphabet does not need to add unnecessary stress to your retirement. At MedicareFAQ, our Medicare experts are passionate about fully educating seniors on all things Medicare.

Call us at the number above to begin your Medicare journey with MedicareFAQ today. If now is not the best time for you to call, our licensed agents can reach out first on your time. To get connected, complete our online rate form today!

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

42 thoughts on “Medicare Part B

  1. I have not taken part B because I have an employer plan covering both my wife and myself. I am retiring and will have to sign up for part B as I have been collecting SSI for two years. My wife has not started SSI because we want to wait for her to turn age 70. Do I have to enroll her in part B at the same time as I am due to the company policy being void?

    1. To avoid a late enrollment penalty for your wife, you would need to enroll her in Part B once you lose group coverage.

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