What is Medicare Part B?

Medicare Part B helps cover medically-necessary services like doctors’ services and tests, outpatient care, home health services, durable medical equipment, and other medical services.

Is it mandatory to buy Medicare Part B?

Medicare Part B is optional, but in some ways, it can feel mandatory, because there are penalties associated with delayed enrollment. As discussed later, you don’t have to enroll in Part B, particularly if you’re still working when you reach age 65. … You have a seven-month initial period to enroll in Medicare Part B.

Can you add Medicare Part B at any time?

You can sign up for Medicare Part B at any time that you have coverage through current or active employment. Or you can sign up for Medicare during the eight-month Special Enrollment Period that starts when your employer or union group coverage ends or you stop working (whichever happens first).

What Does Medicare Part B Cover? [2022 Update]

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What are the building blocks of Medicare?

Original Medicare is the federal health insurance program for seniors (those 65+ years old).

Medicare Part A is the hospital insurance portion, covering inpatient services (e.g., hospital or skilled nursing facility stays), while:

Medicare Part B is the medical insurance portion of Original Medicare, and covers outpatient services (e.g., doctor visits, lab tests, medical equipment, and more).

In this certified mumbo-jumbo-free guide, we’ll cover four questions:

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What Does Part B Of Medicare Cover in 2022?

Part B of Medicare covers doctor’s bills, outpatient hospital services, durable medical equipment, and other medically-related goods and services.

Examples Of Covered Services

Part B covers a variety of outpatient services and medically-necessary preventive services.

Outpatient Medical Services

Ambulance services (emergencies)
Chemotherapy
Dialysis
Lab testing
Transplants
Mental health services (outpatient)
Durable medical equipment (wheelchairs, scooters, monitors, among much more)

Preventive Services

Bone density measurements
Cancer screenings like those for breast, colorectal, and prostate cancers
Cardiovascular disease screenings
Diabetes screenings
Screenings for hepatitis B, hepatitis C, HIV, and STIs
Vaccines (e.g., flu, hepatitis B, and pneumococcal disease)

What Medicare Part B Does NOT Cover

Part B doesn’t cover everything, though. For example, you’ll have to pay for these common senior needs out-of-pocket:

Routine physical examinations
Prescription drugs
Dental care (including dentures)
Vision care (including eyeglasses / contact lenses)
Hearing aids
Cosmetic surgery

Enrolling in Medicare Part B

Americans 65 or older are eligible for the Federal Medicare Program, particularly Parts A and B Medicare coverage.

(People under age 65 with specific disabilities may also be eligible through Social Security Disability Insurance or Supplemental Security Income).

Should You Enroll In Medicare Part B?

To decide whether or not to enroll in Medicare Part B, ask yourself the below two questions.

1. Are You Receiving Social Security Benefits?

If you are already receiving Social Security benefits when you turn 65, you will automatically be enrolled in Parts A & B. Coverage will begin on the 1st of the month that you turn 65.

The government will deduct your Part B monthly premiums ($144.50 in 2022) from your Social Security check.

To cancel your automatic enrollment in Part B, let your local Social Security office know, in writing, at least 15 days before your Initial Enrollment Period ends.

2. Do You Have Employer Health Coverage?

If you like the group health insurance coverage you have through your employer, you can stick with that.

If you’re still working at 65, you can keep your employer coverage. If you lose that coverage, you will have 8 months to enroll in Medicare Part A & Part B.

This Special Enrollment Period will begin when you stop working OR when your employer coverage ends (whichever happens first).

But you’ll want to plan and contact Social Security before your employer coverage ends, so you don’t have a coverage gap.

Enrolling in Part B Medical Insurance Coverage

When you are first eligible for Medicare, you may apply at any time during the 7-month initial enrollment period, which begins three months before the month of your 65th birthday and lasts until the end of the third month following your birth month.

You can apply for Part B by calling Social Security at (800) 772-1213.

What happens if you don’t sign up for Part B?

Suppose you do not enroll in Medicare Part B during your 7-month Initial Enrollment Period or 8-month Special Enrollment Period (for those previously on employer group coverage). In that case, you may have to pay a lifetime late enrollment penalty.

In addition, you will only be able to enroll in Part B during the Medicare General Enrollment Period (from January 1 to March 31 each year), and your coverage won’t start until July. This may cause a gap in your coverage.

How Much Does Medicare Part B Cost In 2022?

Your out-of-pocket costs with Medicare Part B come in three forms:

A monthly premium ($144.50 in 2022)
An annual deductible ($203)
Coinsurance requirements (usually 20%), after you meet your deductible

Table: Medicare Part B Coverage

Note that your Medicare Part B premium will vary by income.

Medigap Can Help With Affordability

If you believe you will have difficulty affording your Part B premiums or the other out-of-pocket expenses that come with your care, consider purchasing Medicare Supplement Insurance. These plans are sold by private insurance companies like Cigna and Humana.

Medicare supplement insurance plans do not cover additional services. They help you with your Original Medicare out-of-pocket costs – i.e., copayments, coinsurance, and deductibles.

Medicare Part B FAQs

What is Medicare Part B?

Medicare Part B helps cover medically-necessary services like doctors’ services and tests, outpatient care, home health services, durable medical equipment, and other medical services.
Is it mandatory to buy Medicare Part B?

Medicare Part B is optional, but in some ways, it can feel mandatory, because there are penalties associated with delayed enrollment. As discussed later, you don’t have to enroll in Part B, particularly if you’re still working when you reach age 65. … You have a seven-month initial period to enroll in Medicare Part B.
Can you add Medicare Part B at any time?

You can sign up for Medicare Part B at any time that you have coverage through current or active employment. Or you can sign up for Medicare during the eight-month Special Enrollment Period that starts when your employer or union group coverage ends or you stop working (whichever happens first).

Conclusion

We hope you enjoyed this introduction to Medicare Part B!

If you have any additional questions or suggestions, don’t hesitate to leave a comment here, and we’ll be sure to get back to you within 24 hours.

Warm Regards,
The GetSure Team

Rikin Shah

Rikin is the Co-Founder & CEO of GetSure. He is a licensed life, accident & health insurance agent in all 50 states (plus D.C.) and has over 15 years of experience in the financial services industry. He holds a B.S. in Applied Mathematics from Columbia University and an MBA from The Stanford Graduate School of Business. If you'd like to speak with Rikin to discuss your life insurance options or questions, don't hesitate to email him at hello [at] getsure.org.