Medicare Part B Coverage: An Expert Guide (2023)

Medicare includes coverage from four different plans (Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D) that cover various services. When you enroll in Medicare health insurance, you should understand what each part covers and how much they cost.

If you’re wondering, “What is Medicare Part B?” read below to learn about what it covers, how much it costs, and whether you qualify for coverage.

Enter your ZIP code into our free quote comparison tool above to find affordable health insurance or a supplemental Medicare plan from a company near you.

What is Medicare Part B?

Medicare Part B is one of the primary parts of Medicare. Medicare Part B provides coverage for doctor’s visits and outpatient care. Part B may also cover preventative services. Medicare Part A and Part B make up what is known as Original Medicare.

Medicare Part B is optional, but most people qualify for the coverage at some point. If you are older than 65, have a disability, or have End-Stage Renal Disease, you meet Medicare Part B eligibility requirements.

What does Medicare Part B cover?

The services that Medicare Part B covers can be split into two categories: medically necessary health services and preventative services.

Medicare Part B will cover the following:

• Clinical research studies
• Ambulance transportation when medically necessary
• Durable medical equipment (DME), such as blood sugar meters and test strips, canes and crutches, CPAP devices, hospital beds, infusion pumps and supplies, oxygen equipment, walkers, wheelchairs, and more
• Outpatient mental health services, such as depression screenings, therapists that accept Medicare, family counseling, psychiatric evaluation, diagnostic tests, and more
• Some outpatient prescription drugs, such as medications used with DMEs, antigens, osteoporosis injections, blood-clotting factors, oral End-Stage Renal Disease (ESRD) drugs, and more

If you have questions about whether Medicare Part B will cover a specific service or product, you may begin by talking with your doctor. Your doctor may be able to work with you to make sure your treatment is covered.

You can also use the Medicare coverage search to see the details of your coverage.

How much does Medicare Part B cost?

There is a monthly premium that you must pay for Medicare Part B. If you receive benefits from Social Security, the Railroad Retirement Board, or the Office of Personnel Management, your premium will be automatically taken out of your benefit payment.

If you don’t receive benefits, you will receive a bill for your premium. While most people pay the standard premium for Medicare Part B, some people who earn more will pay an Income Related Monthly Adjustment Amount (IRMAA) using your IRS tax return from two years ago.

The standard premium for Medicare Part B is $170.10 per month in 2022. However, the premium can go up to $578.30 per month based on your income.

The deductible for Medicare Part B is $233 in 2022. After you pay this deductible, you will be responsible for 20% of the Medicare-Approved Amount for most doctor services, outpatient therapy, and durable medical equipment (DME).

How do I receive Medicare Part B?

Some people who meet the eligibility requirements for Medicare Part B may be enrolled automatically, or you may need to apply manually.

For example, if you receive retirement or disability benefits, you will be enrolled automatically since your benefits application also serves as your Medicare application.

People in these groups who are automatically enrolled have the option to delay their Medicare Part B coverage.

If you do not receive benefits but would like to apply for Medicare Part B, you can do so once you meet specific eligibility requirements. For example, people who are turning 65 can apply up to three months before turning 65. In addition, those who have End-Stage Renal Disease can apply at any time.

The initial Medicare Part B enrollment period for those turning 65 begins three months before they turn 65, includes their birthday month, and ends three months after their birthday.

Open enrollment for Medicare occurs from October 15 to December 7. During this time, people can switch between Original Medicare and Medicare Part C or add or change Medicare Part D plans.

General enrollment for Medicare occurs from January 1 to March 31. During this time, people can apply for Medicare if they did not do so during their initial enrollment period.

Some people may receive special enrollment periods if they decide to delay their enrollment for an approved reason.

Should I get Medicare Part B?

While people can choose whether to enroll in Medicare Part A, it is not an option to enroll in Social Security or Medicare Part B.

Do you need Medicare Part B? You will need to pay for Medicare when you turn 65, and will be required to enroll in Medicare Part B unless you already have health insurance from you or your spouse’s employer. After the health insurance policy ends, you will be required to enroll in Medicare Part B.

If you need help finding affordable health insurance or a supplemental Medicare plan, enter your ZIP code into our free quote comparison tool below to get quotes from companies near you.