Medicare Part B (which — combined with Part A — makes up Original Medicare), provides health insurance coverage for medical services. It covers physician care and outpatient medical services, among other things.
Medicare Part B is optional. If you're automatically enrolled, you can opt out of it.
What Does Medicare Part B Cover?
Part B is considered medical insurance. It covers physician care and outpatient medical services, as well as durable medical equipment (DME).
Some of the health care services covered by Part B can include:
- Your initial physical exam when you join Medicare (called your Welcome to Medicare visit)
- Yearly wellness exams
- Doctor services
- Nursing care
- Ambulance services
- Diagnostic tests and screenings
- Certain pap smear and mammography screenings
- Pneumonia and flu vaccinations
- Durable medical equipment
The medical care services listed above are only part of all of the health insurance benefits offered by Medicare Part B.
What Is the Cost of Medicare Part B for 2020?
Your Part B costs will typically come in the forms of premiums, deductibles, copayments, and coinsurance.
Medicare Part B comes with a monthly premium. Most people pay the standard Part B premium, which is $144.60 per month in 2020.
If you are in a higher income bracket, though, you may pay have to pay more. You only have to pay a higher 2019 Part B premium if your yearly income is over $85,000 individually or $170,000 as a couple.
This increased amount is called the Medicare Income-Related Monthly Adjustment Amount (IRMAA).
Deductibles, Copayments and Coinsurance
Medicare Part B comes with a $198 annual deductible in 2020. Part B won’t pay for anything until you pay that amount each year that you use the coverage.
After you pay the deductible, you still pay for a portion of the services covered by Part B. This is usually 20% of the Medicare-approved amount for the service. Part B covers the other 80%.
If you don’t want to pay for deductibles or coinsurance, some Medicare Supplement insurance (also called Medigap) plans can help cover these and other out-of-pocket Medicare costs.
How Do I Get Medicare Part B?
Medicare Part B is optional. If you are automatically enrolled in Medicare Part A (hospital insurance), you will be automatically enrolled in Part B, but you may choose to opt out of it.
When you receive your red, white and blue Medicare card in the mail, you can follow the opt-out instructions that come attached and send the card back. If you don’t follow these instructions, you will get Part B and must pay the monthly premiums.
If you automatically enrolled in Part A and Part B, you will have to manually enroll in Medicare at your local social security office or through social security’s online portal.
The best time to enroll in Part B is during your Medicare Initial Enrollment Period (IEP). This period begins three months before you turn 65 years old, includes the month of your birthday and continues on for three additional months.
What Is the Medicare Part B Late Enrollment Penalty?
If you do not sign up for Medicare Part B when you first become eligible or during your Initial Enrollment Period, you will be subject to a late enrollment penalty if you choose to sign up later on.
The late enrollment penalty is 10% of the Part B premium for each full 12-month period that you were eligible for Part B but did not sign up.
You will have to pay the late enrollment penalty for as long as you are enrolled in Part B.
One exception to this rule is if you or your spouse are working and have employer-provided group health insurance coverage when you first become eligible for Medicare.
In this case, you can continue to remain in your group health plan without enrolling in Medicare. Once you lose your employer coverage, you can typically enroll in Part B during a Special Enrollment Period (SEP) without having to pay the Part B late enrollment penalty.
Can I Get Help Paying for Medicare Part B?
Medigap plans can help cover Part B costs such as Part B coinsurance and Part B excess charges.
You can use the chart below to compare each of the 10 standardized Medigap plans available in most states and the benefits they offer.
Scroll to the right to continue reading the chart
Medicare Supplement Benefits
Part A coinsurance and hospital coverage
Part B coinsurance or copayment
Part A hospice care coinsurance or copayment
First 3 pints of blood
Skilled nursing facility coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel emergency
|Medicare Supplement Benefits||A||B||C*||D||F1*||G1||K2||L3||M||N4|
|Part A coinsurance and hospital coverage|
|Part B coinsurance or copayment||50%||75%|
|Part A hospice care coinsurance or copayment||50%||75%|
|First 3 pints of blood||50%||75%|
|Skilled nursing facility coinsurance||50%||75%|
|Part A deductible||50%||75%||50%|
|Part B deductible|
|Part B excess charges|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C as long as they are available in your area.+ Read more
1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2 Plan K has an out-of-pocket yearly limit of $6,220 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3 Plan L has an out-of-pocket yearly limit of $3,110 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.- Read less
Medicare beneficiaries who become eligible for Medicare after January 1, 2020, will not be eligible to enroll in Plan C or Plan F. If you already have Plan C or Plan F before 2020, you will be able to keep your plan.
Call today to speak with a licensed insurance agent who can help you find Medicare Supplement plans that are available where you live.
Compare Medigap plans in your area.Find a plan
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