Medicare Part B

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

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

Also, Part B will cover the services that 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.

The out of pocket costs for Part B includes a premium, deductible, and coinsurance. Part B will cover 80% of your medical expenses once you’ve met the annual deductible. If you have a Medigap plan, the yearly deductible and coinsurance could have coverage.

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. We’ll cover more on that below.

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.

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

Most people pay the standard premium amount. However, those with a gross income above a certain amount may pay an Income Related Monthly Adjustment Amount.

Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS. If you have a change in circumstance, you can appeal to your IRMAA.

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 find out how to enroll online, over the phone, or in-person here.

All beneficiaries will have an Initial Enrollment Period window for Part B enrollment. 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.

In most cases, if you do not sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B. Your monthly premium will go up 10% for each full 12-month period you go without coverage.

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.