Part B
What is Medicare Part B?
Medicare Part B is one of the two parts of Original Medicare and provides medical coverage. Beneficiaries who are eligible for the Medicare Part A are also eligible for enrollment in Part B once they are entitled to Part A.
Medicare Part B is a voluntary program that requires payment of a monthly premium for all months of coverage.
What does Part B cover?
How do I find out if Medicare covers what I need?
- Talk to your doctor or other health care provider about why you need certain services or supplies. Ask if Medicare will cover them. You may need something that is usually covered, but your provider thinks Medicare won't cover it in your situation. If so, you will need to read and sign a notice. The notice says you may have to pay for the item, service, or supply.
- Find out if Medicare covers your item, service or supply.
What factors determine Medicare coverage?
- Federal and state laws.
- National coverage decisions made by Medicare about whether something is covered.
- Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide if something is medically necessary and should be covered in your area.
What is not covered by Part B?
- Most dental care.
- Eye examinations related to the prescription of eyeglasses.
- Dentures.
- Cosmetic surgery.
- Massage therapy.
- Routine physical examinations.
- Acupuncture.
- Hearing aids and fitting tests.
- Long-term care.
How much does Part B cost?
Part B premiums
The standard Part B premium amount in 2021 is $148.50 and most people will pay this amount. However, if your modified adjusted gross income is above a certain threshold, you may pay an income-related monthly adjustment amount (IRMAA).
Your Part B premium will be automatically deducted from your benefit payment if you obtain benefits from one of the following:
- Social Security
- Railroad Retirement Board
- Office of Personnel Management
If you do not receive one of these benefit payments, you will receive a quarterly bill for your Medicare Part B premium.
Penalty for late registration
If you didn't get Part B when you were first eligible, your monthly premium may increase by 10% for each 12-month period that you could have had Part B but didn't sign up. In most cases, you will have to pay this penalty each time you pay your premiums for as long as you have Part B.
Part B deductible and coinsurance
In 2021, you will pay $203 toward your Part B deductible. After you meet your annual deductible, you normally pay coinsurance of 20% of the Medicare-approved amount for the following approved services:
- Most medical services (even while you are in the hospital)
- Outpatient therapy
- Durable Medical Equipment (DME)
