Medicare 101

Everything You Need to Know About Medicare Part B

Christian Worstell

by Christian Worstell | Published April 30, 2020 | Reviewed by John Krahnert

Medicare Part B is Original Medicare’s medical insurance, with coverage for doctor visits and other kinds of outpatient care. But while it covers a broad variety of care, Medicare Part B does leave some out-of-pocket costs to you. Here’s everything you should know before you enroll.

Understanding Medicare Part B

Anyone who is enrolled in Medicare Part A has the option to enroll in Medicare Part B. Together, Medicare Part A and Medicare Part B are also known as Original Medicare.

Eligibility 

To be eligible for Medicare Part B you must be enrolled in Medicare Part A. Most people become eligible for Medicare Part A when they turn 65 or after their 24th month of receiving Social Security disability benefits.

Enrollment

Medicare Part B is optional. If you’re already receive Social Security or Railroad Retirement Board retirement benefits when you turn 65, you’ll be automatically enrolled in Part A and Part B. If you decide you don’t want Part B, follow the instructions that accompany your Medicare card.

If you’re still working when you turn 65, you’ll need to manually enroll. The best time to enroll in Medicare Part B is during your seven-month initial enrollment period (IEP), which begins three months before your 65th birthday.

If you fail to enroll in Medicare Part B during your IEP, you will likely have to pay a late enrollment penalty for as long as you have Medicare Part B.1

You can enroll in Medicare Part B online at CMS.gov.

Coverage

Medicare Part B covers services and supplies needed to treat a disease or condition. This includes:

  • Visits with primary care doctors
  • Consultations with specialists
  • Operations performed by specialists
  • Physical therapy, speech therapy, and occupational therapy
  • Clinical research studies
  • Ambulatory services
  • Medical equipment such as canes, blood sugar test strips, commode chairs, infusion pumps and more
  • Mental health treatment

Medicare Part B also covers preventive care to help prevent and treat health conditions early on. Preventive care includes services such as immunizations and annual wellness exams. You should always take advantage of your annual wellness exam, as it offers a free, yearly opportunity to review or uncover any health issues you may be facing.

Medicare Part B does not cover prescription drugs. If you would like coverage for prescription drugs, you must enroll in Medicare Part D.

Costs

Unlike Medicare Part A, which usually does not require you to pay a monthly premium, you are required to pay a premium for your Medicare Part B coverage. In 2019, the average Part B premium is $135.50.

In addition to your monthly premium, you will be responsible for some out-of-pocket costs, including:

  • Annual deductible. Each year, you must spend a certain amount out of pocket before Medicare starts paying its share. In 2019, the Medicare Part B deductible is $185.
  • Coinsurance. You typically pay 20% of all Medicare-approved costs of medical services, after you’ve met your deductible.

Once you enroll in Medicare Part B, you are eligible to also enroll in a Medicare Supplement Insurance plan. Medicare Supplement Insurance (also known as Medigap) is insurance sold by private insurers that helps cover some of your Medicare Part A and Part B out-of-pocket costs.

To learn more about Medigap, including which plans are available in your area, speak with a licensed agent at 1-800-995-4219.

Recommended Reading

 

1 https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html

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