What Is Medicare Part B, and What Does It Cover?

Medicare Part B is optional, low-cost medical insurance for seniors. It covers outpatient treatment and preventive care.

Amy Beardsley
Written byAmy Beardsley
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Amy BeardsleyInsurance Writer
  • 3+ years writing about auto, home, and life insurance

  • 7+ years in personal finance and technology

Amy specializes in insurance and technology writing and has a talent for transforming complex topics into easy-to-understand stories.

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Evelyn Pimplaskar
Evelyn PimplaskarEditor-in-Chief, Director of Content
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  • 30+ years in media, PR, and content creation

Evelyn leads Insurify’s content team. She’s passionate about creating empowering content to help people transform their financial lives and make sound insurance-buying decisions.

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Updated June 20, 2024

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Medicare Part B is part of Original Medicare. Part B is an optional medical insurance plan for adults 65 and older, younger people who have disabilities, and people with end-stage renal disease (permanent kidney failure). It helps pay for preventive care, like flu shots and cancer screenings, and medically necessary services such as doctor visits, lab tests, medical equipment, and outpatient procedures.

In 2024, the standard Part B premium is $174.70 per month, but some people with higher incomes may pay more.[1]

What does Medicare Part B cover?

If you decide to enroll in it — you can choose not to enroll — Medicare Part B covers a wide range of medically necessary outpatient services and preventive care, such as:

  • Doctor visits: Doctor visits for diagnosis, treatment, and consultations with specialists qualify for coverage through Part B.

  • Outpatient procedures: Part B covers many outpatient surgeries and procedures, such as X-rays, lab tests, stitches, casts, and endoscopies.

  • Certain prescription medications: If they’re part of your service or procedure, Part B will cover certain prescription drugs.

  • Medical equipment: Part B helps pay for things like blood sugar monitors, wheelchairs, walkers, hospital beds, and CPAP machines if your doctor prescribes it.

  • Ambulance services: If it’s medically necessary for you to travel by ambulance, airplane, or helicopter, Part B would pay for your transportation. In some cases, it may cover non-emergency ambulance services, too.

  • Preventative care: Part B covers many screenings and preventive services like flu shots, mammograms, colonoscopies, bone density scans, and annual wellness visits.

  • Clinical research: Part B covers certain office visits and tests as part of qualifying clinical research studies.

  • Mental health care: You can use your Part B coverage for outpatient mental health, care like therapy, counseling, and partial hospitalization programs.

  • Home healthcare: In limited situations, Part B covers someone to care for you in your own home.

Other parts of Medicare

Part B is an important component of Medicare, but it’s just one piece of the program. Other parts of Medicare include:[2]

  • illustration card https://a.storyblok.com/f/162273/150x150/ef30c81b80/veterinary-96x96-yellow_033-nurse.svg

    Part A (hospital insurance)

    Part A covers things like inpatient stays, skilled nursing facility care, hospice care, and some home healthcare. It doesn’t cover outpatient visits like Part B.

  • illustration card https://a.storyblok.com/f/162273/150x150/2331a79dc9/medical-services-96x96-orange_009-eye.svg

    Part C (Medicare Advantage)

    As an alternative to Original Medicare, Part C bundles Part A, Part B, and (usually) Part D. Private companies offer Medicare Advantage plans, and they can include extra benefits like vision, hearing, and dental services that Part B doesn’t cover.

  • illustration card https://a.storyblok.com/f/162273/150x150/e80155814a/medicine-96x96-green_037-drugs.svg

    Part D (prescription drug coverage)

    Part D covers medications that Part B won’t pay for. Private insurance companies run these programs.

  • illustration card https://a.storyblok.com/f/162273/150x150/1d8803fded/credit-and-loan-96x96-blue_019-calendar.svg

    Medigap (Medicare supplemental insurance)

    Medigap plans are available from private insurance companies in addition to Original Medicare. Plans help cover your share of costs like copayments, co-insurance, and deductibles. You might find Medigap plans with names like Plan G or Plan K.

Learn More: Medigap vs. Medicare Advantage: Which Plan is Best for You?

Learn More: Medigap vs. Medicare Advantage: Which Plan is Best for You?

What won’t Medicare Part B cover?

Medicare Part B is limited and leaves some gaps in your healthcare coverage. Some examples of what Part B doesn’t cover include:

  • Long-term care: Part B doesn’t cover extended nursing home stays or assisted living.

  • Routine dental, vision, and hearing care: Part B doesn’t cover dental care, eyeglasses, or hearing aids. Some exceptions apply, like vision care after cataract surgery.

  • Most prescription drugs: Part B only covers certain outpatient drugs under limited conditions. For most prescriptions, you need Part D.

  • Cosmetic surgery: Unless medically necessary, Part B doesn’t pay for procedures like nose reshaping.

  • Care outside of the U.S.: Medicare doesn’t cover you if you’re outside the U.S.

Good to Know

If you’re traveling outside the U.S., Medicare won’t cover you, so it’s a good idea to buy travel insurance. It may be more expensive for seniors, especially if you have a pre-existing condition. But travel insurance can provide you with medical coverage and even evacuation assistance if you fall ill or get injured while outside the country.

How much Medicare Part B costs

Medicare aims to provide low-cost health insurance for seniors on limited incomes. But you’ll have to kick in some of your own cash for Part B, similar to employer-sponsored plans and Affordable Care Act Plans (also called Obamacare) plans. Here’s a breakdown of key costs as of 2024.

Medicare Part B premiums

Your tax-filing status and annual income determine how much you pay for Medicare Part B. Your cost is usually deducted from your Social Security benefits. Most people pay $174.70 per month, which is the cheapest premium available. If you earn a higher income, you may pay more, as shown here.

Single FilersMarried Filing Jointly Married Filing SeparatelyMonthly Premium
$103,000 or lessUp to $206,000Up to $103,000$174.70
More than $103,000 up to $129,000More than $206,000 up to $258,000N/A$244.60
More than $129,000 up to $161,000More than $258,000 up to $322,000N/A$349.40
More than $161,000 up to $193,000More than $322,000 up to $386,000N/A$454.20
More than $193,000 but less than $500,000More than $386,000 but less than $750,000More than 103,000 but less than $397,000$559
$500,000 or more$750,000 or more$397,000 or more$594

Medicare Part B deductibles

The annual Part B deductible is $240. You pay this amount out of your own pocket before Medicare starts covering services.

Unlike Part A, in which a deductible applies each time you’re hospitalized, you’ll only pay your Part B deductible once each year. The deductible resets each year.

Medicare Part B co-insurance

Co-insurance comes into play after you meet the deductible. For most doctor services, outpatient therapy, and durable medical equipment, you’ll pay 20% of the cost.

Unfortunately, Medicare Part B doesn’t limit the annual co-insurance costs.

Keep Reading: When Does Medicare Coverage Start?

Keep Reading: When Does Medicare Coverage Start?

How to enroll in Medicare Part B

To enroll in Medicare Part B, you’ll apply with the Social Security Administration. The program encourages you to apply online, but you can also send your application by mail or fax.[3] After signing up, you’ll get a welcome package, including your Medicare card, in the mail.

Enrollment periods

Medicare offers three enrollment periods throughout the year:

  • Initial Enrollment Period: It lasts for seven months and includes the three months before you turn 65, the month you turn 65, and the three months after your 65th birthday. 

  • General Enrollment Period: It runs from Jan. 1March 31 each year.

  • Special Enrollment Period: It has a limited window if you lost Medicaid or employer healthcare coverage, were incarcerated, or meet other specific conditions.

If you don’t enroll during your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, you may have to pay a penalty — and it isn’t a one-time fee. You’ll pay an extra 10% on top of your monthly premium for every year that you fail to sign up for Part B.

Eligibility requirements

You must meet certain eligibility requirements to enroll in Medicare Part B:[3]

  • Age 65 or older

  • U.S. resident

  • U.S. citizen or permanent legal resident who’s lived in the U.S. for at least five years before applying

If you’re younger than 65, you may be eligible for Part B if you have Social Security disability insurance for 24 months, have end-stage renal disease, or have Lou Gehrig’s disease (also called amyotrophic lateral sclerosis, or ALS).

Original Medicare vs. Medicare Advantage plans

You can choose between two main paths for your Medicare coverage: Original Medicare or Medicare Advantage. The federal government runs Original Medicare, while private insurance companies offer Medicare Advantage as an alternative to Original Medicare.

What is Original Medicare?

Original Medicare includes Part A and Part B. Together, it covers inpatient hospital stays, skilled nursing facility care, hospital care, some home healthcare, doctor visits, outpatient care, and medical supplies. You can see any provider that accepts Medicare, and you have the option to add Part D prescription drug coverage.

What is Medicare Advantage?

Also known as Part C, Medicare Advantage is an “all-in-one” plan available through private insurers that bundles Part A, Part B, and usually Part D benefits. You typically need to see doctors in the plan’s network, but you may pay less from your own pocket than with Original Medicare.

What is Medicare supplemental insurance (Medigap)?

Medigap is a supplemental insurance policy that helps pay for costs Original Medicare doesn’t cover, like your Part A and Part B deductibles, copays, and co-insurance. Private insurers offer Medigap plans with letter names (like Plan G or Plan K).

If you opt for Original Medicare and expect high medical costs, a Medigap plan may be a good idea since Part B doesn’t have a cap on how much you’ll pay out of pocket.

Important Information

If you choose a Medicare Advantage plan, you won’t be able to buy Medigap coverage. But if you change your mind about your Advantage plan, you have 12-month “trial rights” that allow you to drop your Part C plan and return to Original Medicare.[4]

Medicare Part B FAQs

Enrolling in Medicare Part B can feel like a confusing decision. The following information can help you through the process.

  • What’s the difference between Medicare Parts A, B, and C?

    Medicare Part A pays for inpatient hospital stays and skilled nursing facilities. Part B picks up the tab for doctor visits, outpatient care, and preventive services. Part C is Medicare Advantage, an alternative to Original Medicare, that combines Part A, B, and usually D.

  • Does everyone pay for Medicare Part B?

    Most people pay the standard Part B monthly premium. If you have a low income, you could qualify for a Medicare Savings Program to help cover the costs. But Part B is optional. You can have Part A without signing up for Part B.[5]

  • How much does Medicare Part B cost per month?

    The standard Medicare Part B premium is $174.70 (as of 2024). People with higher incomes pay more, ranging from $224.60–$594 per month. Keep in mind you’ll also be responsible for the $240 annual deductible and may have to cover 20% after meeting your deductible.

  • Who’s eligible for Medicare Part B?

    You’re eligible for Part B once you turn 65 and are a U.S. citizen or permanent resident, as long as you’ve lived in the U.S. for at least five continuous years before applying. You may also qualify before age 65 if you have a disability, Lou Gehrig’s disease, or end-stage renal disease.

  • Can you opt out of Medicare Part B?

    Yes. You can opt out of Medicare Part B coverage. You can also choose to not enroll in Medicare at all. But you may have to pay a late-enrollment penalty if you opt out and later change your mind.

Sources

  1. Medicare.gov. "What's Medicare?."
  2. Medicare.gov. "Parts of Medicare."
  3. Social Security Administration. "Sign up for Part B only."
  4. Centers for Medicare & Medicaid Services. "Medicare Advantage Plans and Other Medicare Plans."
  5. U.S. Department of Health and Human Services. "What is Medicare Part B?."
Amy Beardsley
Amy BeardsleyInsurance Writer

Amy is a personal finance and technology writer. With a background in the legal field and a bachelor's degree from Ferris State University, she has a talent for transforming complex topics into content that’s easy to understand. Connect with Amy on LinkedIn.

Evelyn Pimplaskar
Edited byEvelyn PimplaskarEditor-in-Chief, Director of Content
Evelyn Pimplaskar
Evelyn PimplaskarEditor-in-Chief, Director of Content
  • 10+ years in insurance and personal finance content

  • 30+ years in media, PR, and content creation

Evelyn leads Insurify’s content team. She’s passionate about creating empowering content to help people transform their financial lives and make sound insurance-buying decisions.

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