What is Medicare Part B?

Original Medicare, provided by the federal government, has two parts: Part A and Part B. Medicare Part B covers doctor visits, preventative care, many emergency medical services and other outpatient costs like physical therapy. Medicare Part A helps pay for inpatient hospital stays, skilled nursing care, hospice care and some home-health services.

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?

While Medicare Part A is free for most Americans, Medicare Part B has a monthly premium. If you’re receiving Social Security benefits, your Medicare Part B premium is automatically deducted from your monthly Social Security check. If you’re not receiving Social Security benefits, you will need to send a monthly premium payment to Medicare.

Medicare Part B premiums are based on your household income. Some individuals with higher incomes pay more, while low income individuals may qualify for reduced premiums. Keep in mind that if you’re married, Part B premiums are individual, not combined. Premiums are set each year by the Centers for Medicare and Medicaid Services (CMS), so your premium may change from year to year.

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

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

Like Medicare Part A, you’re automatically enrolled in Medicare Part B if you receive Social Security retirement benefits. If you do not receive retirement benefits, you must enroll in 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 are covered by a spouse’s employer healthcare plan, you may choose not to sign up for Medicare Part B. To delay Medicare Part B enrollment, contact Social Security. You will be able to enroll in Medicare Part B at a later date without paying a late penalty.

It’s important to understand all your Medicare options. HelloMedicare can help. Learn more about the Medicare coverage available in your area with our personalized Guided Path tool.