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What is Medicare Part B?

Medicare Part B at work, as a female patient and doctor discuss preventive healthcare

Medicare Part B is the part of Original Medicare that covers regular doctor visits, preventive care, and everyday healthcare. The medical care that Medicare Part B covers is what you will probably use most over time. Original Medicare also includes Part A, which covers inpatient care like hospitalizations.

What does Medicare Part B cover?

Think of Part B as your personal health toolkit. Every time you need to visit a doctor, receive medical tests or X-rays, or use outpatient services, Part B covers that.

For the most part, Medicare Part B coverage is all about preventive healthcare. Preventive healthcare helps you stay healthy with screenings, vaccinations, and positive lifestyle changes. This type of care has a vital impact on your overall, long-term health.

Essential vaccinations
Medicare Part B includes annual flu shots and other important vaccinations for staying healthy.

Screening for health conditions
Chronic illnesses and health conditions are best treated when you and your doctor notice them early. That’s why Part B includes screenings for diabetes, breast cancer, cardiovascular disease, and more.

Your annual checkup
Part B covers yearly visits to the doctor, which help ensure you are on track to good health as part of a complete preventive program.

Healthy lifestyle changes
Part B also helps you make lifestyle changes to improve your health. For example, if you need help to stop smoking or lose weight, Part B covers smoking cessation programs and medically approved weight loss programs.

What does Medicare Part B not cover?

While Medicare Part B covers a great deal, here are a few examples of what it doesn’t cover:

  • Routine dental, hearing, and vision care
  • Medical services outside the U.S.
  • Alternative medicines

What is the difference between Medicare Part A and Part B?

Medicare Part A primarily covers inpatient care including hospitalization costs. Medicare Part B covers outpatient care such as preventive medicine and doctor visits.
Medicare Part A coverage Medicare Part B coverage
Hospital stays Doctor visits
Skilled nursing facility Outpatient care
Hospice care Medical supplies
Some home healthcare Some preventive services

When are you eligible for Medicare Part B?

In general, Medicare eligibility requires that you be 65 or older and a U.S. citizen or legal U.S. resident for at least five continuous years to qualify. You may also apply for Medicare if you are younger than 65 and have certain disabilities. If you currently have Part A coverage, you are also eligible for Part B.

When to sign up for Medicare Part B

Medicare Part A and Part B enrollment is automatic if you’re already collecting Social Security. If you’re not collecting and meet the age requirement, you can apply for Medicare through Social Security during your Initial Enrollment Period, which is:

  • Three months before your 65th birthday month
  • Your 65th birthday month
  • Three months after your 65th birthday month

How to sign up for Medicare Part B

To sign up for Medicare Part B, you can visit SocialSecurity.gov, call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday from 7 a.m. to 7 p.m., or go to your local Social Security office.

What are the premiums for Medicare Part B?

Many who apply for Medicare may not have to pay a Part A premium if they or a spouse contributed through payroll deductions while working.

However, nearly everyone must pay a premium for Medicare Part B. Because Part B is based on your income level, your Medicare Part B cost can vary.

Most applicants pay a standard premium amount. If your modified adjusted gross income is more than a certain amount, you may pay an Income-Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your federal tax return from a two-year period.

When do you start receiving Part B coverage?

This depends on when and if you applied during your Initial Enrollment Period:

  • If you applied one to three months before the age of 65, it starts the month you turn 65
  • If you applied in your 65th birthday month, it starts the following month
  • If you applied two to three months after turning 65, it starts three months after you sign up
  • If you applied during the General Enrollment Period, which is January 1 to March 31, your coverage starts on July 1 of that year

Explore more coverage than Original Medicare (Part A and Part B)

Because Original Medicare doesn’t cover everything, it sometimes makes more sense to pick a plan that includes prescription drug coverage, and/or dental, vision, and hearing insurance. That’s why many people opt for a Medicare Advantage plan or Part D Plan. Be sure to consider all your coverage options.

Compare costs and find a Medicare plan that’s right for you.
 

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