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Your Guide to Medicare Part B

Medicare is a federal health insurance program for people age 65 and older and some younger Americans with certain disabilities and illnesses. Medicare is made up of four different parts: Part A (hospital insurance), Part B (medical insurance), Part C (an alternative to Parts A and B offered by private insurers) and Part D (prescription drug insurance).

What is Medicare Part B?

Original Medicare is made up of two parts: Medicare Part A and Medicare Part B. Medicare Part B covers doctor visits, preventative care, many emergency medical services and other outpatient costs like physical therapy. Medicare Part B coverage is optional.

What Does Medicare Part B Cover?

Medicare Part B covers the care you receive as an outpatient in a clinic or hospital. It also covers the doctor services you receive during an inpatient hospital stay.

Specific Medicare Part B coverage includes:
  • Routine doctor visits or annual wellness checks
  • Ambulatory surgery center services
  • Preventative care (e.g., flu shots, screening mammograms)
  • Outpatient mental health services
  • Clinical lab tests (e.g., blood and urine tests)
  • Diagnostic tests (e.g., MRI, X-rays, CT scans)
  • Durable medical equipment
  • Emergency Room services
  • Part-time skilled nursing care or health aide services

Medicare Part B does not provide comprehensive prescription drug coverage.

How Much Does Medicare Part B Cost?

Medicare Part B has a monthly premium. If you’re receiving Social Security benefits, your Medicare Part B automatically deducts your premium from your monthly Social Security check. If you’re not receiving Social Security benefits, you must send a monthly premium payment to Medicare.

Household incomes determine your Medicare Part B premiums. Some higher-income individuals pay more, while low-income individuals may qualify for reduced premiums. Remember that if you’re married, Part B premiums are individual, not combined. The Centers for Medicare and Medicaid Services (CMS) annually sets premiums, making them subject to change yearly.

For more information, please visit: Part B costs | Medicare

When and How Can I Sign Up for Medicare Part B?

You’re automatically enrolled in Medicare Part B if you receive Social Security retirement benefits. If you do not receive retirement benefits, you must register for Medicare Part B by filing a request with Social Security during your Initial Enrollment Period (IEP) or the General Enrollment Period (GEP).

If you are still working and covered by an employer healthcare plan or a spouse’s employer healthcare plan, you may choose not to sign up for Medicare Part B. To delay Medicare Part B enrollment, contact the Social Security office. You will be able to enroll in Medicare Part B later without paying a late penalty.

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