Medicare Part B

What it covers: Outpatient Insurance

Medicare Part B includes (but not limited to) the following medical services and supplies

  • Doctor visits
  • Emergency ambulance services
  • Laboratory tests and X-rays
  • Durable medical equipment
  • Mental health services
  • Preventive services, such as flu shots, pap tests, and screenings
  • Rehabilitative services, including occupational therapy, speech-language pathology services, and physical therapy

In general, medical procedures that don’t require an overnight stay at a hospital or nursing home or skilled at-home care are covered by Medicare Part B.

Who does it cover

Medicare Part B is outpatient medical insurance offered by the federal government to United States citizens and legal immigrants. You’re eligible if you’re 65 and older. Also certain disabilities can qualify you under age 65. Individuals who are eligible for premium-free Medicare Part A are also eligible for enroll in Part B once they are entitled to Medicare Part A.

Medicare Part B provides coverage for outpatient services necessary to treat medical conditions, such as doctor’s visits, lab work, x-rays, outpatient surgeries, preventive services, and medical equipment. Medicare Part A provides coverage for hospital related costs such as hospital stays, nursing care, hospice, and home-health care.

While many people qualify for premium-free Medicare Part A coverage, everyone has to pay insurance premiums for Medicare Part B.

What Does Medicare Part B Cost?

Your monthly premium is based on your income level and when you enroll. You’re eligible to enroll in most cases when you turn 65. The normal Part B standard monthly premium is $134.00 if any of the following applies to you if:

  • You began Part B insurance in 2017
  • You have not yet received Social Security or Railroad Retirement Board benefits
  • You are eligible for both Medicare and Medicaid
  • You are directly billed for your Part B premium

Note that if you enroll if you enroll in Medicare Part B late you will have to pay a penalty. Premiums can also be higher depending on your income level. Calculations can be complex, but you can contact the Social Security Administration online at www.SocialSecurity.gov for help.

You can also do so at your local social security office or by calling the national hotline at 1-800-772-1213 (TTY users 1-800-0778) weekdays between 7AM and 7PM eastern time.

Medicare Part B – Coverage and Payments

Medicare Part B provides coverage for outpatient services to treat medical conditions, such as doctor’s visits, lab work, x-rays, outpatient surgeries, preventive services, and medical equipment. For individual services and supplies, your Medicare Part B costs may vary.

The annual deductible for Medicare Part B in 2017 is $183 per year. You have to meet this deductible before you’re eligible for most payments.

Some preventive services are completely covered without requiring you to meet your deductible, if your provider accepts Medicare assignment. After this deductible is met, you often pay about 20% of the Medicare-approved amount. You may also owe a copayment for certain outpatient services.

Who Signs Up Automatically

If you’re already collecting Social Security or Railroad Retirement Board (RRB) retirement benefits when you turn 65, you will automatically be enrolled in Medicare Part B.1

If you are disabled and receiving Medicare Part A when you turn 65, will be automatically enrolled in Medicare Part B.

While most people are enrolled in Medicare Part B automatically, you can also manually sign up for coverage. If you don’t receive either Social Security or RRB (possibly because you are still working), then you will have to sign up manually.

You can enroll in Medicare Part B three months before you turn 65 for coverage that starts when you turn 65.

If you are not enrolled automatically, be careful as you should sign up manually at least 3 months before you turn 65 to avoid possible penalties.

Where to Sign Up Manually

You can do this online at www.SocialSecurity.gov

You can also do so at your local social security office or by calling the national hotline at 1-800-772-1213 (TTY users 1-800-0778) weekdays between 7AM and 7PM eastern time.

Your coverage for Medicare Part A can begin as early as 6 months before the time you filed, but no earlier than the month you met all Part A requirements.

Eligibility

You must have worked 10 years under Medicare Covered Employment by the time you are 65 to receive free Medicare Part B.

If you are not eligible for free Medicare Part B, you can purchase it along with Medicare Part A during the general enrollment period or the special enrollment period.

The general enrollment period is every year January 1st to March 31.

The special enrollment period can occur for a number of different reasons. If you or your spouse continue to work and receive health insurance coverage from an employer, your Special Enrollment Period continues indefinitely. If you lose your job or your health coverage with that job, you have a Special Enrollment Period for 8 months. There are other exceptions, so check with your local Social Security office if you have questions.

More Information ⇢

1 If you are living in Puerto Rico, you will be automatically enrolled in Medicare Part A (if you are receiving Social Security or RRB benefits), but not Part B. You must manually sign up for Medicare Part B.

Find Affordable

HEALTH INSURANCE

  1. Enter your zip code
  2. Provide basic information about you and your needs
  3. Insurance professionals will provide you plan options and quotes

Compare

Medicare Plans

  1. Enter your zip code
  2. Provide basic information about you and your needs
  3. Insurance professionals will provide you plan options and quotes

Get Your

Medical Records

  1. Provide contact information
  2. Get quick and secure access to your medical history
  3. Save time and take control of your records!