Medicare Part B - Medical Insurance & Doctors Visits
What is Medicare Part B?
Medicare Part B is a health insurance program administered by the federal government which primarily helps cover non-hospital medical needs including doctor services, outpatient care, lab work, ambulance, and medical equipment costs. Part A and Part B are also known as “Original Medicare”.
Who is eligible for Part B?
In general, people 65 or older and those who qualify by disability are eligible for Part B. Younger people with certain disabilities can also be eligible for Part B.
Typically you have to be eligible for Part A in order to be eligible for Part B. People are usually not automatically enrolled as Part B is a voluntary program.
What does Part B cover?
Part B helps cover doctor visits, medical supplies, and other services considered medically necessary to treat your condition. Medical services covered include:
- Doctor Visits
- Medical supplies and services
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Getting a second opinion before surgery
- Limited outpatient prescription drugs, like those administered in a doctor's office
Is there a monthly plan premium cost for Part B?
Yes, the standard monthly plan premium amount for Part B in 2024 is $174.70, but this can be greater if you have a high income.
If you receive Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment.
What are the out-of-pocket costs (deductible, coinsurance) for Part B?
Part B has a $240 annual deductible. After you reach the deductible level, you will typically pay a 20% coinsurance of the approved amount for Medicare Part B services.
When can I sign up for Part B?
There is a 7 month initial enrollment period for Part B. You can enroll starting 3 months before the month you turn 65, during the month you turn 65, and 3 months after your birthday month. Other enrollment time periods apply if you are eligible due to disability or End-Stage Renal Disease (ESRD).
Is there a penalty for signing up late for Part B?
Yes, you will usually have to pay a late enrollment penalty if you do not sign up for Part B when you are first eligible. The penalty may cause your Part B monthly plan premium to go up 10% for each 12 month period you could have had Part B but did not sign up. The penalty usually does not apply if you are eligible for a Special Enrollment Period.
More information
For more information on this topic, please visit www.medicare.gov