Medicare Part B Coverage: An Expert Guide (2024)
What is Medicare Part B? Medicare Part B is one of the main parts of Medicare that covers outpatient care, routine doctor's visits, and preventative care. The Medicare Part B premium can range from $170.10 to $578.30 per month. There is also a deductible of $233 and coinsurance of 20% of the Medicare-approved amount for services. In addition, some of your Medicare Part B expenses can automatically be taken out of your benefit checks.
Read moreFree Medicare Insurance Comparison
Compare Quotes From Top Companies and Save
Secured with SHA-256 Encryption
Tracey L. Wells
Licensed Insurance Agent & Agency Owner
Tracey L. Wells is a licensed insurance agent and Farmers insurance agency owner with 23 years of experience. He is proud to be a local Farmers agent serving Grayson, Georgia and surrounding areas. With experience as both an underwriter and agent, he provides his customers with insight that others agents may not have. His agency offers all lines of insurance including home, life, auto, RV, busi...
Licensed Insurance Agent & Agency Owner
UPDATED: Nov 27, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.
UPDATED: Nov 27, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Part B is one of the four main parts of Medicare that covers doctor’s visits, outpatient treatments, and preventative services
- Some of the services that Medicare Part B covers include doctors visits, clinical research, ambulance services, and more
- Costs associated with Medicare Part B include a premium ranging between $170.10 and $578.30 per month, a deductible of $233, and coinsurance of 20% of the Medicare-Approved Amount of services
Medicare includes coverage from four different plans (Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D) that cover various services. When you enroll in Medicare health insurance, you should understand what each part covers and how much they cost.
If you’re wondering, “What is Medicare Part B?” read below to learn about what it covers, how much it costs, and whether you qualify for coverage.
Enter your ZIP code into our free quote comparison tool above to find affordable health insurance or a supplemental Medicare plan from a company near you.
Table of Contents
What is Medicare Part B?
Medicare Part B is one of the primary parts of Medicare. Medicare Part B provides coverage for doctor’s visits and outpatient care. Part B may also cover preventative services. Medicare Part A and Part B make up what is known as Original Medicare.
Medicare Part B is optional, but most people qualify for the coverage at some point. If you are older than 65, have a disability, or have End-Stage Renal Disease, you meet Medicare Part B eligibility requirements.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
Secured with SHA-256 Encryption
What does Medicare Part B cover?
The services that Medicare Part B covers can be split into two categories: medically necessary health services and preventative services.
Medicare Part B will cover the following:
- Clinical research studies
- Ambulance transportation when medically necessary
- Durable medical equipment (DME), such as blood sugar meters and test strips, canes and crutches, CPAP devices, hospital beds, infusion pumps and supplies, oxygen equipment, walkers, wheelchairs, and more
- Outpatient mental health services, such as depression screenings, therapists that accept Medicare, family counseling, psychiatric evaluation, diagnostic tests, and more
- Some outpatient prescription drugs, such as medications used with DMEs, antigens, osteoporosis injections, blood-clotting factors, oral End-Stage Renal Disease (ESRD) drugs, and more
If you have questions about whether Medicare Part B will cover a specific service or product, you may begin by talking with your doctor. Your doctor may be able to work with you to make sure your treatment is covered.
You can also use the Medicare coverage search to see the details of your coverage.
How much does Medicare Part B cost?
There is a monthly premium that you must pay for Medicare Part B. If you receive benefits from Social Security, the Railroad Retirement Board, or the Office of Personnel Management, your premium will be automatically taken out of your benefit payment.
If you don’t receive benefits, you will receive a bill for your premium. While most people pay the standard premium for Medicare Part B, some people who earn more will pay an Income Related Monthly Adjustment Amount (IRMAA) using your IRS tax return from two years ago.
The standard premium for Medicare Part B is $170.10 per month in 2022. However, the premium can go up to $578.30 per month based on your income.
The deductible for Medicare Part B is $233 in 2022. After you pay this deductible, you will be responsible for 20% of the Medicare-Approved Amount for most doctor services, outpatient therapy, and durable medical equipment (DME).
How do I receive Medicare Part B?
Some people who meet the eligibility requirements for Medicare Part B may be enrolled automatically, or you may need to apply manually.
For example, if you receive retirement or disability benefits, you will be enrolled automatically since your benefits application also serves as your Medicare application.
People in these groups who are automatically enrolled have the option to delay their Medicare Part B coverage.
If you do not receive benefits but would like to apply for Medicare Part B, you can do so once you meet specific eligibility requirements. For example, people who are turning 65 can apply up to three months before turning 65. In addition, those who have End-Stage Renal Disease can apply at any time.
The initial Medicare Part B enrollment period for those turning 65 begins three months before they turn 65, includes their birthday month, and ends three months after their birthday.
Open enrollment for Medicare occurs from October 15 to December 7. During this time, people can switch between Original Medicare and Medicare Part C or add or change Medicare Part D plans.
General enrollment for Medicare occurs from January 1 to March 31. During this time, people can apply for Medicare if they did not do so during their initial enrollment period.
Some people may receive special enrollment periods if they decide to delay their enrollment for an approved reason.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
Secured with SHA-256 Encryption
Should I get Medicare Part B?
While people can choose whether to enroll in Medicare Part A, it is not an option to enroll in Social Security or Medicare Part B.
Do you need Medicare Part B? You will need to pay for Medicare when you turn 65, and will be required to enroll in Medicare Part B unless you already have health insurance from you or your spouse’s employer. After the health insurance policy ends, you will be required to enroll in Medicare Part B.
If you need help finding affordable health insurance or a supplemental Medicare plan, enter your ZIP code into our free quote comparison tool below to get quotes from companies near you.
Case Studies: Medicare Part B Coverage
Case Study 1: Johnson Insurance Company
Mary Thompson, a 65-year-old retiree, enrolled in Medicare Part B after retiring from her job. She had a pre-existing medical condition that required regular visits to specialists. Mary found that Medicare Part B covered a significant portion of her healthcare costs, including doctor visits, diagnostic tests, and durable medical equipment.
However, she discovered that certain services, such as dental and vision care, were not covered. Mary supplemented her coverage by purchasing additional dental and vision insurance through Johnson Insurance Company, ensuring comprehensive care for her specific needs.
Case Study 2: BrightHealth Insurance
John Davis, a 68-year-old Medicare beneficiary, required frequent physical therapy sessions due to a chronic condition. He opted for Medicare Part B coverage to access the necessary rehabilitation services. Initially, John faced some challenges when it came to obtaining coverage for his therapy sessions.
However, with the assistance of BrightHealth Insurance, he successfully appealed the denials and received the coverage he deserved. This case highlights the importance of understanding the appeals process and working with an insurer that can advocate for the beneficiary’s rights.
Case Study 3: Golden Health Insurance
Sara Johnson, a 70-year-old Medicare recipient, sought Medicare Part B coverage to address her ongoing arthritis pain. She found that Medicare Part B covered most of her physician visits, laboratory tests, and outpatient treatments. However, when she required a new medication prescribed by her doctor, she discovered that it was not on the Medicare Part B formulary.
Sara worked with Golden Health Insurance to explore alternative medications covered under her plan, ultimately finding a suitable alternative that helped manage her arthritis symptoms effectively.
Case Study 4: Liberty Insurance Company
Mike Adams, a 72-year-old Medicare beneficiary, required regular medical equipment, including a wheelchair and oxygen supplies. With Medicare Part B coverage, Mike was able to access the necessary durable medical equipment.
However, he faced challenges when he needed replacements or repairs. Mike contacted Liberty Insurance Company, which guided him through the process of obtaining timely replacements and repairs, ensuring that his healthcare needs were met without interruption.
Case Study 5: Sunrise Health Insurance
Lisa Rodriguez, a 67-year-old Medicare enrollee, underwent surgery for a cardiac condition. She found that Medicare Part B covered a significant portion of her hospital stay, doctor fees, and post-surgical care. However, Lisa incurred additional costs for prescription medications she required during her recovery period.
Sunrise Health Insurance provided Lisa with valuable information about Medicare Part D prescription drug coverage, allowing her to enroll in a suitable plan and reduce her out-of-pocket expenses for medications.
Frequently Asked Questions
What is Medicare Part B?
Medicare Part B is one of the main parts of Medicare that covers outpatient care, routine doctor’s visits, and preventative care. The Medicare Part B premium can range from $170.10 to $578.30 per month. There is also a deductible of $233 and coinsurance of 20% of the Medicare-approved amount for services. In addition, some of your Medicare Part B expenses can automatically be taken out of your benefit checks.
What does Medicare Part B cover?
Medicare Part B covers medically necessary health services such as doctor’s visits, outpatient care, and durable medical equipment. It also includes preventative services like screenings, vaccinations, and counseling to prevent illness or detect it at an early stage.
How much does Medicare Part B cost?
The monthly premium for Medicare Part B is $170.10 per month in 2022, but it can go up to $578.30 per month based on your income. There is also a deductible of $233 in 2022, and after reaching the deductible, you are responsible for 20% of the Medicare-approved amount for most services.
How do I receive Medicare Part B?
Some people are automatically enrolled in Medicare Part B, while others may need to apply manually. If you receive retirement or disability benefits, you will be enrolled automatically. If not, you can apply once you meet specific eligibility requirements. Enrollment periods and deadlines vary, so it’s important to understand when you can apply.
Should I get Medicare Part B?
Enrolling in Medicare Part B is generally required when you turn 65 and are no longer covered by health insurance from you or your spouse’s employer. However, if you already have sufficient health insurance, you may have the option to delay enrollment. It’s important to evaluate your individual circumstances and consider factors such as coverage needs and costs.
Where can I find affordable health insurance or supplemental Medicare plans?
To find affordable health insurance or supplemental Medicare plans, you can use a free quote comparison tool that provides quotes from different insurance companies. By entering your ZIP code, you can receive quotes from companies near you, allowing you to compare options and potentially save on coverage costs.
Pros:
- Medicare Part B provides coverage for outpatient care, doctor’s visits, and preventative services.
- Medicare Part B helps cover medically necessary health services and offers access to preventive screenings and vaccinations.
- Automatic deduction of Medicare Part B premiums from benefit checks simplifies the payment process.
- Medicare Part B enrollment is often automatic for individuals receiving retirement or disability benefits.
- Medicare Part B offers flexibility in enrollment periods and deadlines, allowing for timely application.
Cons:
- Medicare Part B has a monthly premium, deductible, and coinsurance, which can vary based on income and expenses.
- Not all services or products may be covered by Medicare Part B, so it’s important to check with your doctor or use the Medicare coverage search for details.
- Applying for Medicare Part B may require manual enrollment for some individuals, and deadlines for enrollment can be specific.
- Enrolling in Medicare Part B is generally required, which means you may need to pay premiums even if you have other health insurance coverage.
- Depending on your income, you may have to pay an Income Related Monthly Adjustment Amount (IRMAA) in addition to the standard premium.
Please note that the pros and cons listed above are general considerations and may vary based on individual circumstances. It’s always recommended to consult with an insurance professional or Medicare representative to get personalized advice.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
Secured with SHA-256 Encryption
Tracey L. Wells
Licensed Insurance Agent & Agency Owner
Tracey L. Wells is a licensed insurance agent and Farmers insurance agency owner with 23 years of experience. He is proud to be a local Farmers agent serving Grayson, Georgia and surrounding areas. With experience as both an underwriter and agent, he provides his customers with insight that others agents may not have. His agency offers all lines of insurance including home, life, auto, RV, busi...
Licensed Insurance Agent & Agency Owner
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.