Medicare Part B is the other half of what is known as Original Medicare. Part B is your doctor’s or inpatient coverage.
What is Medicare Part B?
Medicare Part B is the “medical insurance” part of Original Medicare. It helps pay for most health care costs involving outpatient hospital care, outpatient surgeries and rehab, and basic medical checkups.
Most beneficiaries purchase Medicare Part A and Part B together, but there are circumstances under which that might not be ideal. It all depends on your costs, eligibility, and exact retirement date, among other factors.
How Much is Medicare Part B?
Part B Premium
The standard monthly premium for Medicare Part B is $174.70. The cost does go up depending on your income. This cost adjustment is known as the Income Related Monthly Adjustment Amount. However, only about 7% of beneficiaries pay the IRMAA.
Income Related Monthly Adjustment Amount
The Income Related Monthly Adjustment Amount is based on your income from two years prior.| Beneficiaries who file individual tax returns with modified adjusted gross income: | Beneficiaries who file joint tax returns with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly Premium Amount in 2023 |
|---|---|---|---|
| $97,000 or less | $194,000 or less | $0.00 | $164.90 |
| $97,000 to $123,000 | $194,000 to $246,000 | $65.90 | $230.80 |
| $123,000 to $153,000 | $246,000 to $306,000 | $164.80 | $329.70 |
| $153,000 to $183,000 | $306,000 to $366,000 | $263.70 | $428.60 |
| $183,000 to $500,000 | $366,000 to $750,000 | $362.60 | $527.50 |
| $500,000 or above | $750,000 or above | $395.60 | $560.50 |
Part B Deductible
The annual deductible for Part B is $240. This deductible is a direct out-of-pocket cost. But once you meet your deductible, you’ll only pay a 20% cost share for the Medicare-approved price of all your medical care going forward for the rest of the calendar year.
If you enroll in Part B late, you will be subject to a late enrollment penalty. That penalty takes your monthly premium for Part B and adds a 10% surcharge for every year you did not enroll after age 65.
Who’s Eligible for Medicare Part B?
Since Part B is voluntary, there are different eligibility requirements. If you qualify for premium-free Part A, you also qualify for Part B.
Remember that if you enroll in each part separately, there are specific dates for enrolling in Part B. You can’t just join anytime you want.
Suppose you have to pay for Part A. In that case, you must be at least 65 years of age, a resident of the country, and either a legal citizen or a lawfully admitted, permanent resident alien with at least five continuous years of residency before filing your Medicare application.
People under the age of 65 with a qualifying medical disability like Lou Gehrig’s Disease or ESRD can also qualify for Part B. Contact your local Centers for Medicare & Medicaid Services office for more information.
What Does Medicare Part B Cover?
Part B covers two essential things: medically necessary and preventative services.
Medically necessary services include anything you need to diagnose or treat a medical condition.
Preventive Services include yearly wellness checkups, flu shots, or standard medical tests designated to detect diseases early, thus reducing the cost of treatment and the likelihood of bad outcomes.
You can also count on Part B for the following:
- Durable medical equipment
- Ambulance services
- Clinical research
- Mental health services, including inpatient, outpatient, and partial hospitalization services
- Limited outpatient prescription drugs
What Does Part B Not Cover?
Part B does not cover your health care costs associated with any inpatient hospital treatment. It does not cover any benefits explicitly outlined in Part A, including hospice care, skilled nursing facilities, and home health care services.
How to Sign Up for Part B?
Your enrollment will be automatic for anyone about to turn 65 and currently receiving Social Security benefits. You should receive your Medicare card in the mail within three months of your 65th birthday.
You will have to wait to apply with your local Centers for Medicare & Medicaid Services office if you’re not eligible for automatic enrollment. For Part B, you can only enroll during your Initial Enrollment Period, the annual General Enrollment Period, Or a Special Enrollment Period.
FAQs
We understand that Medicare can be complicated for a lot of people. It’s almost inevitable that most beneficiaries who read this page will still have questions. We hope we can answer some of them in the FAQ below. You can also contact us directly if you feel like we have not sufficiently answered any of your questions here.
What is the Part B premium for 2023?
The standard Part B premium is $174.70. The Medicare Part B premium is fluid and can increase or decrease yearly.
Why do I need Medicare Part B?
Not all beneficiaries need to enroll in Part B immediately. If you still have good insurance through your employer, which takes care of your medical insurance needs, you can wait to enroll in Part B until your employer’s insurance no longer covers you. Make sure you file all the paperwork correctly once you transition into Part B, or you may be subject to a late enrollment penalty.
Does Medicare Part B cover prescriptions?
As stated above, there are limited prescriptions that Part B will pay for if it’s necessary and related to your outpatient care. Otherwise, you’re going to have to rely on Medicare Part D.
Do you always have to pay for Medicare Part B?
Yes. You will have to pay the monthly premium, annual deductible, and 20% coinsurance costs for as long as you’re enrolled in Part B. If you enroll in a supplemental Medicare plan, you’ll still pay your Part B premium, but the other cost-sharing amounts may differ.
Can I cancel Medicare Part B?
Yes, you can volunteer to end your Part B benefits. But you will likely be subject to a personal interview with a Social Security representative from the Centers for Medicare & Medicaid Services office.
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