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Medicare Part B


Medicare Part B is the medical portion of Original Medicare. This includes coverage for services provided by your doctors that are preventive and medically necessary.

What Does Medicare Part B Cover

Medicare Part B Coverage

Part B provides coverage for a mixture of outpatient medical services. This includes coverage for preventive vaccines, cancer screenings, annual lab work, and much more.

It will cover preventive services in addition to specialist services. Part B even covers services for mental healthcare, durable medical equipment that your doctor finds medically necessary.

Also, Part B will cover some services you receive while in the hospital. This includes surgeries, diagnostic imaging, chemotherapy, and dialysis if you obtain drugs while at the hospital, it will also provide coverage for those.

Medicare Part B Coverage Chart

What Does Medicare Part B Not Cover

Part B does not provide dental or vision benefits. It also doesn’t cover anything not considered medically necessary or preventive. Additionally, it won’t cover prescriptions taken at home or long-term care. 

How Much Does Medicare Part B Cost

The out-of-pocket costs for Part B include a premium, deductible, and coinsurance. Part B will cover 80% of your medical expenses once you’ve met the annual deductible. You must pay the monthly premium for Part B. Most beneficiaries will pay the standard monthly premium. Those in a higher income bracket will pay more.

In 2021, the Part B premium is $148.50 a month. If you receive Social Security, Railroad Retirement Board, or Office of Personnel Management benefit payments, your Part B premium will be deducted from your monthly check. Part B has an annual deductible of $203. This deductible can slightly increase each year.

If you don’t receive Social Security, you could get a monthly bill from Medicare. They have an online payment option called Easy Pay for those with a MyMedicare account.

Does Medicare Part B cover 100 Percent

Part B covers 80% of your medical costs and also comes with an annual deductible and monthly premium.

Does Medicare Part B Have a Copay

No, Medicare Part B does not come with copays.

Who Qualifies for Free Medicare Part B

If you’re a lower-income beneficiary and are dual-eligible for both Medicare & Medicaid, you may be eligible for a Medicare Savings Program that will pay all or most of your Part B premium.

How to Sign Up for Medicare Part B

Beneficiaries collecting Social Security benefits when they age into Medicare at 65 will automatically be enrolled. You’ll receive your Medicare card the month before your birthday. If you’re not collecting Social Security benefits, you’ll need to enroll yourself. You can apply online, over the phone, or in-person.

All beneficiaries will have an Initial Enrollment Period for both Part A & Part B. This period begins three months before the month you turn 65th birthday and ends three months after. If you don’t enroll during your Initial Enrollment Period and don’t have creditable coverage, you could be subject to a penalty.

You won’t pay the penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period. An example would be if you continued working past 65 and had creditable coverage through an employer group health insurance.

How to Reinstate Medicare Part B

Go to MyMedicare.gov website and log into your account. Complete the application and include all the required documents. You can track the status in your dashboard.

FAQs

Does Medicare Part B cover prescriptions?
Part B will cover prescriptions administered in an outpatient setting.
How long does it take to get Part B after applying
It can take up to 30-60 days to be approved if you’re applying outside your initial enrollment period and not automatically enrolled.
Am I required to pay the Part B deductible upfront
No, your doctor will need to bill Medicare first. Then, Medicare will then bill you for the deductible. When you pay this upfront, Medicare has no record of it, and you’re still expected to meet the deductible.
Can I sign up for Medicare Part B online?
Yes, you can sign up for Part B online at www.socialsecurity.gov.
Do you pay the Part B premium with Medicare Advantage?
Yes, you still must pay the monthly premium for Part B when you enroll in a Medicare Advantage plan. Some plans do come with a premium reduction benefit.
Do I have to pay for Medicare Part B if I have other insurance?
Depending on the insurance you have, you might be able to delay Medicare Part B without penalty.
How do I avoid the Medicare Part B premium?
The only way to avoid paying the Part B premium is to qualify for a Medicare Savings Program.
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.
Do you have to pay for Medicare Part B if you have an Advantage plan?
Yes, you still have to pay the monthly Part B premium to have an Advantage plan.
Does everyone pay the same for Medicare Part B?
Most beneficiaries pay the same amount for Medicare Part B. However, those in a higher-income bracket do pay more as well as those in a lower income bracket may get assistance with paying their Part B premium.
Can I add Medicare Part B at any time?
No, there are two enrollment windows to enroll in Part B unless you have a special circumstance. The first opportunity to enroll is during your Initial Enrollment Period, the second opportunity is during the annual General Enrollment Period.
Is Medicare Part B based on income?
No, eligibility for Part B is not based on income. It’s based on your age or disability.

How to Get Help with Medicare Part B

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

6 thoughts on “Medicare Part B

  1. If you are being billed for part B and are now ready to sign up for SSI will they
    start taking it out of your SSI or do they still bill you.

    1. Hi Norman! If you have a Medicare Advantage plan I would contact your carrier directly to get the correct forms necessary. Normally, you’re responsible for 100% of the cost if the provider is out of network.

  2. How do I submit to Medicare for my provider accepting only at the time of the appointment and does not bill insurance?

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