Medicare Part B: Medical Insurance
Medicare Part B, also known as medical insurance, helps cover medically necessary outpatient services and supplies used to diagnose or treat health conditions. It also includes preventive services designed to help detect illnesses early and support overall health
Part B generally covers doctor visits, outpatient care, preventive screenings, and durable medical equipment. Unlike Medicare Part A, Part B requires a monthly premium. Most beneficiaries pay the standard premium amount, though premiums may vary based on income.
What Does Medicare Part B Cover?
Medicare Part B covers a wide range of services, including:
- Doctor visits (primary care and specialists).
- Outpatient care and procedures.
- Preventive services (e.g., flu shots, cancer screenings, annual wellness visits).
- Diagnostic tests (e.g., lab work, imaging).
- Durable medical equipment (e.g., walkers, wheelchairs, oxygen equipment).
- Ambulance services.
- Chemotherapy, dialysis, and other medically necessary treatments.
It’s important to note that Part B does not cover routine dental, vision, hearing care, hearing aids, most prescription drugs, or alternative treatments like acupuncture (except in limited cases).
Who Is Eligible for Medicare Part B?
You are eligible for Medicare Part B if:
- You are 65 or older.
- You are under 65 and have a qualifying disability.
- You have End-Stage Renal Disease (ESRD).
- You are 65 or older, and you or your spouse paid Medicare taxes for at least 10 years (40 quarters).
- You are under 65 and have a qualifying disability or End-Stage Renal Disease (ESRD).
Medicare Part B is an important part of your coverage and is required unless you have creditable health insurance through an employer with 20 or more employees (or through a spouse’s employer with 20 or more employees). If you delay enrolling in Part B without this type of coverage, you may face a late enrollment penalty. That’s why many people choose to enroll as soon as they are eligible. Depending on your situation, you may be automatically enrolled in Part B or may need to actively sign up.
Out-of-Pocket Costs with Medicare Part B?
The standard monthly premium for Medicare Part B is set annually and may be higher based on your income (using your tax return from two years prior). In addition to the monthly premium, you’re responsible for:
- An annual deductible.
- Coinsurance, typically 20% of the Medicare-approved amount for services.
Need Help Navigating Medicare?
Understanding Medicare and choosing the right coverage can feel overwhelming, but you don’t have to do it alone. Our team of licensed local agents, we can guide you through the process and help you make informed decisions about your healthcare and retirement needs.
We can help you:
- Understand your Medicare options and eligibility.
- Review plan costs, benefits, and coverage choices.
- Avoid late enrollment penalties.
- Find a plan that fits your health needs and budget.
Get Personalized support from a trusted local professional. Call (210) 340-0777 (TTY:711) or text (726) 213-6777 for a free, no obligation consultation to help you navigate Medicare options.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).