What is Medicare Part B?

Kimberly Lankford,

AARP

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En español

Published July 22, 2022

/ Updated May 09, 2024

One of Medicare’s four main parts, Part B covers doctors’ services, diagnostic screenings, lab tests, preventive services and outpatient care, plus some medical equipment and transportation.

The other types of coverage fall under:

Part A, which helps pay for inpatient stays in hospitals and skilled nursing facilities, some home care and end-of-life hospice care. Together, Part A and Part B are known as original Medicare.

Part C, also known as Medicare Advantage, which is a private health insurance alternative to federally run original Medicare. You still need to sign up for Medicare Parts A and B if you choose to get coverage from a Medicare Advantage plan.

Part D, which is prescription drug coverage. You can get Part D through a stand-alone policy or from a Medicare Advantage plan.

What services does Medicare Part B cover?

Part B covers the bulk of your medical needs beyond hospitalization and prescription drugs, including:

Doctor visits or appointments with other health care providers, including some doctor services when hospitalized.
Diabetes care, including education, certain equipment, prevention programs and screenings.
Diagnostic tests, including CT scans, electrocardiograms, MRIs and X-rays.
Durable medical equipment, such as wheelchairs and walkers, that your doctor prescribes for use in your home.
Emergency department and outpatient surgery center services, as well as other outpatient hospital services.
Some health programs, such as cardiac rehabilitation, obesity counseling and smoking cessation.
Laboratory services, such as blood and urine tests.
A limited number of prescription drugs that you usually don’t administer yourself, such as insulin from an external insulin pump that’s not disposable. Insulin you administer yourself is covered under Medicare Part D instead.
Outpatient mental health services.
Outpatient physical therapy, occupational therapy and speech and language pathology services.
Preventive care, such as flu shots and mammograms, to help avert illness or detect it at an early stage. Many preventive services are covered without deductibles or copayments; however, some vaccinations, such as the shingles vaccine, are covered under Part D instead.
A Welcome to Medicare checkup and the annual wellness visit, which are covered in full without deductibles or copayments, unless additional tests are ordered.

Even though Part B covers many doctor services, it doesn’t cover everything. Part B generally doesn’t cover routine dental, hearing and vision care.

What’s more, care not considered medically necessary, such as elective cosmetic surgery, isn’t covered, either. Chiropractor and acupuncture visits are paid for only if you meet very specific criteria, and Part B doesn’t cover medical services outside the United States, except in rare circumstances.

How much does Medicare Part B cost?

Even though Medicare Part B covers many of your expenses for doctor services and outpatient care, you will have some out-of-pocket costs.

Part B premiums. Most people pay $174.70 a month in 2024 for Medicare Part B premiums. People who are single with an adjusted gross income of more than $103,000 or married filing jointly with income greater than $206,000 pay a high-income surcharge (officially called the Income-Related Monthly Adjustment Amount, or IRMAA) with premiums ranging from $244.60 to $594.00 a month, depending on income level.

Premiums are based on your last tax return on file, which is usually 2022 income for 2024 premiums.

If you don’t enroll in Medicare when you’re first eligible or qualify for a special enrollment period to sign up later, you may have to pay a late enrollment penalty, which is added to your Part B premiums for as long as you have the coverage.

Deductible. You must pay a $240 deductible in 2024 before most Part B coverage begins. However, the Welcome to Medicare checkup, the annual wellness visit and some preventive care are not subject to any deductible or coinsurance unless your doctor orders additional tests.

Coinsurance. After paying the deductible, you’ll generally pay 20 percent of the Medicare-approved amount for most doctor and outpatient services and for durable medical equipment.

Extra charges. Doctors who don’t accept assignment, which means they don't agree to take the amount Medicare approves for their services, can charge up to 15 percent above the Medicare-approved amount for a service, which you would have to pay in addition to the 20 percent copayment for doctor services.

Keep in mind

Want Medicare Advantage? The Medicare Advantage plan must provide as least as much coverage as original Medicare, but you may have different out-of-pocket costs. For example, rather than the Part B deductible and 20 percent coinsurance, a Medicare Advantage plan may have no copayments for in-network primary doctor visits, a $20 copay for diagnostic tests and procedures, $40 copay for specialists and $90 copay for emergency care.

You may be required to use in-network doctors and other providers to receive coverage from the Medicare Advantage plan or have to pay more if you use out-of-network services, depending on the plan.

Need financial help with Medicare’s costs? If you have low income and assets, you may qualify for a Medicare Savings Program that helps pay your Medicare premiums and out-of-pocket costs.

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Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.

What is Medicare Part B?

What services does Medicare Part B cover?

How much does Medicare Part B cost?

Keep in mind

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