Medicare Part B

Old lady talking to her Doctor about Medicare Part BMedicare Part B generally covers two main types of service. The first is medically necessary services and supplies that are needed to treat or even diagnose your medical condition. These must also meet accepted standards of medical practice. The second type of service that Medicare Part B covers is preventive services, like preventing illness when treatment is most likely to work best. For example some shots and vaccines are covered. You can enroll in Medicare Part B medical insurance during the Initial Enrollment Period, which is three months before and four months after your 65th birthday. There is also a special enrollment period for those who are covered by a group health plan offered by a union or employer.

If you are already receiving benefits from Social Security or the Railroad Retirement Board, you will likely be automatically enrolled in Medicare Part B the first day of the month you turn 65: if your birthday is on the first of the month, you will enroll in Medicare Part B on the first day of the previous month. If you are disabled and under the age of 65, you will likely automatically get Medicare Part B once you receive Social Security disability benefits. Most people must pay a monthly premium, the cost of which may change depending on their income, to ensure Medicare Part B coverage. The premium is usually deducted from your monthly Social Security payments depending on income.

If you were automatically enrolled in Medicare Part B, and received a card in the mail, you can choose to opt out by sending the Medicare Part B card back: by keeping the card, you keep Medicare Part B and keep paying Medicare Part B premiums. If you signed up for Medicare through Social Security, contact Social Security. If you chose not to enroll during your Initial Enrollment Period, you have the opportunity to enroll in the General Enrollment Period.  You can sign up during the General Enrollment Period between January 1–March 31 each year. In many cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. For every one year period that you were qualified to enroll in but opted not to, your Medicare Part B monthly premium could increase by 10%. If you meet certain conditions that allow you to sign up during the Special Enrollment Period, you may not have to pay this enrollment penalty.

Medicare Part B provides patients with medically necessary outpatient health care. Medicare Part B fills in some of the Medicare Part A gaps by providing coverage for doctors in an outpatient setting as well as for approved medical equipment and supplies when necessary. Physician services, nursing services, vaccinations, cardiovascular and diabetes screenings, lab services, and other preventive services can all be covered by Medicare Part B however, routine physical exams are not covered. Medicare Part B will not pay for cosmetic surgery, custodial care, prescription drugs, dental care, or vision care, as well as some other services.

Medicare does not cover every health-related service or item. You may have to pay co-payments and deductibles on services even if they are covered by Medicare. After you meet your deductible, your co-payments will generally cost around 20% of the Medicare-approved amount for most doctor services. If a service you need is not covered by Medicare, you must cover the costs yourself unless you have separate insurance that does. Learn more about the cost of Medicare Part B at Medicare.gov.