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Medicare Part B Coverage

Part of the decision-making process of selecting the best Medicare plan for you is having a thorough understanding of Medicare Part B coverage.

Medicare Part B is part of Original Medicare and often referred to as the “doctor part”. Whereas Medicare Part A (the other part of Original Medicare) is sometimes referred to as the “hospital part”. Per Medicare.gov, Medicare’s Part B Coverage includes:

  • Preventive services
  • Medically-necessary services and supplies
  • Clinical research
  • Doctor visits
  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
  • Limited outpatient prescription drugs

Basically, Medicare Part B covers doctors’ services, outpatient care, including any equipment or supplies that are deemed medically-necessary.

Medicare Part B is not free though. See more on that below.

Medicare Part B Does Not Cover:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
  • Hospice care
  • Home health care
  • Long-term care (also called custodial care)
  • Most dental care
  • Eye exams related to prescribing glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care

When to Sign Up for Medicare Part B Coverage

The ideal time to sign up for Medicare Part B is during your Initial Enrollment Period (IEP). This period covers a 7-month window:

  • 3 months before the month you turn 65
  • The month you turn 65
  • 3 months after the month you turn 65

What Happens if You Don’t Sign up for Part B during the Initial Enrollment Period?

It’s important to keep in mind that if you want to have Medicare Part B, delaying enrollment typically means incurring a late enrollment penalty. The Part B penalty is assessed based on how long enrollment was delayed. Furthermore, this penalty is recurring for as long as you have Medicare Part B coverage. However, if you are still covered under your employer’s health care coverage (or your spouse’s) during the 7-month Initial Enrollment Period, then you may enroll in Part B at a later time.

How Much is Medicare Part B Coverage?

According to Medicare.gov, the standard Part B premium amount in 2020 is $144.60. This is what most people will pay. However, there are some exceptions related to income. Here’s a more in-depth look at the 2020 Part B Premiums according to specific tax return brackets.

In addition to your monthly premium, there are also deductibles and 20% co-insurance. Often these extra costs can be burdensome to a fixed budget. Sometimes, these costs result in medical care being delayed, leading to complications that undermine healthy wellbeing.

Finding the Right Coverage

Keep in mind, you do not have to be an expert in all things Medicare. We understand that this can be confusing. Our #1 priority is to guide you on how to navigate Medicare benefits and costs based on your specific situation. Medicare coverage and plans are certainly not a one-size-fits-all.

Contact us for help finding a Plan

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