Medicare Part B (Medical Insurance)
Who is eligible for Part B:
- Anyone eligible for premium-free Medicare Part A is eligible for Medicare Part B by enrolling and paying a monthly premium.
- Some may also qualify for automatic Medicare Part B enrollment through disability. If you are under 65 and receiving Social Security or Railroad Retirement Board (RRB) disability benefits, you will automatically be enrolled in Medicare Part A and Part B after 24 months of disability benefits.
- Some may also be eligible for Medicare Part B enrollment before 65 if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (also known as ALS, or Lou Gehrig’s disease).
What if you are not eligible for Part B:
If you are not eligible for premium-free Medicare Part A, you can qualify for Medicare Part B by meeting the following requirements:
- You must be 65 years or older
- You must be a U.S. citizen, or a permanent resident lawfully residing in the U.S for at least five continuous years.
What’s covered in general under Part B:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts to be paid directly by Medicare.
- Examples of coverages under Part B:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Getting a second opinion before surgery
- Limited outpatient prescription drugs
How much does Part B cost:
- The standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount ($109 on average). Your Part B premium will be automatically deducted from your Soc Sec benefit payment. If you don’t get these benefit payments, you’ll get a bill.
- Part B Deductible & Coinsurance: You pay $183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.