Medicare Part B

• Admin
• 25 Jan 2025

Medicare Part B

Medicare Part B is referred to as “medical insurance” because it includes coverage for a wide range of medically necessary services and supplies. Part B helps pay for doctor visits, outpatient services, and durable medical equipment. It also provides access to many preventive services, including annual cancer screenings and exams.

Let’s break down some of the benefits you’ll receive under Medicare Part B:

Doctor Visits
Part B helps cover the cost of seeing your doctor, including visits to a primary care physician or specialists. If you have Original Medicare, you’ll need to see a physician who accepts assignment. This means the doctor agrees to accept the Medicare-approved amount as full payment. If you're enrolled in a Medicare Advantage plan, you may need to see doctors within the plan’s network and may need referrals to see specialists.

Outpatient Care
Part B covers many outpatient procedures, which are increasingly preferred due to quicker recovery times at home. Even if you stay overnight in the hospital, you may still be considered an outpatient unless formally admitted as an inpatient. In such cases, Part B covers outpatient services, while inpatient care falls under Part A.

Durable Medical Equipment (DME)
If your doctor prescribes equipment for use in your home, such as a wheelchair, oxygen equipment, or hospital bed, Part B helps cover the cost. You must rent or purchase from a Medicare-approved supplier, and you’ll typically pay 20% of the Medicare-approved amount.

Clinical Laboratory Services
Part B covers tests like blood work, urinalysis, and tissue specimen analysis. These services may be ordered to screen for health conditions or to diagnose and treat an illness or injury.

Many Preventive Services
Preventive care through Part B includes annual wellness visits, screenings, and vaccines (like the flu shot). These services aim to detect issues early and improve treatment outcomes. Many are available at no cost if you visit a provider who accepts assignment.

Enrollment in Part B
While enrollment in Part B is optional, signing up during your Initial Enrollment Period helps you avoid late penalties. If you delay enrollment without having creditable coverage, you may face a 10% penalty for each 12-month period you went without coverage.

Why Enroll in Part B?
Some people believe they can delay Part B if they’re healthy. But unexpected illnesses or injuries can lead to high out-of-pocket costs. Part B helps protect you from major expenses related to doctor visits, ambulance services, and outpatient treatments.

Costs for Care under Part B
Most people pay a monthly premium for Part B. In 2022, the standard premium is $170.10, though it may be higher based on income. Part B has an annual deductible of $233, after which Medicare generally pays 80% of approved charges. Preventive services are often free when you visit a doctor who accepts assignment.

To reduce costs not covered by Original Medicare, many beneficiaries choose to buy a Medicare Supplement (Medigap) plan. These plans help pay for copayments, coinsurance, and deductibles not covered by Part B.