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What is Medicare Part B and what does it cover?

Jan 17, 2019 11:34:00 AM / by Stephanie Pogue

Stephanie Pogue

Along with Part A, you also need to know what Medicare Part B covers, what the costs are to you, when you are eligible for benefits and how to enroll for coverage.

Medicare Part B covers doctor and outpatient services or basically, any service that occurs outside of an inpatient hospital setting. This includes your doctor visits, outpatient surgeries, lab tests, radiology tests, emergency room visits, medical equipment as well as many other services. It also covers any preventive testing like the annual Medicare “Wellness Visit”, diabetes screenings and mammograms.

Deductibles and Co-pays

After a small deductible ($185.50 in 2019), Medicare usually pays 80% of the Part B services and the other 20% falls to the Medicare beneficiary. A Medicare Supplement or Medicare Advantage plan is recommended to help pay for these costs.  Preventive services are usually covered at 100% regardless of the type of plan you have.

Premium for Part B

There is a monthly premium for Medicare Part B. If your income is less than $85,000 and you enroll in 2018, the monthly cost is $135.50.  This amount normally increases each year, so people enrolled in previous years most likely pay a lower rate. The premium amount is higher if your annual income is over $85,000.

How and When to Enroll?

If you are already receiving your Social Security benefits, you will automatically be enrolled in Part B when you turn 65 and the premium will be deducted from your Social Security check.

If you are not receiving your Social Security benefits when you turn 65, you will most likely need to apply for your Medicare Part B benefits. You can apply at your local Social Security office or on online at This process should start 3 months prior to your 65th birth month and the effective date is usually the first day of your birth month. If your birth date is on the first day of the month, your Medicare benefits will start the month prior to your birth month.

If you plan to continue working, it’s a good idea to speak with the Human Resources person at your company or a knowledgeable insurance agent who can help you decide if you should enroll in Part B at 65 or wait until you retire. There are advantages of delaying your Part B, but ONLY if you have “credible coverage” with your employer.

If you do not continue your "credible coverage" through your employer,  and you delay your Part B enrollment, you will be charged a Medicare Part B late enrollment penalty. The enrollment periods if you delay are limited as well.

Hopefully, we've answered the question "What is Medicare Part B" and you have a better understanding of what it covers. Next on the list of understanding Medicare is Part C or Medicare Advantage plans.

Related Post: What is Medicare Part C (Medicare Advantage Plans)?

If you prefer, you can also watch our simple Introduction to Medicare videos. 

Better yet, save time and effort and get your free video chat consultation today.



Topics: Medicare

Stephanie Pogue

Written by Stephanie Pogue

Stephanie has been primarily helping seniors and retirees with their healthcare decisions since 1995. In addition, she has recruited and trained agents, developed and promoted managers, and ranked in the Top 3% of Sales Managers at Bankers Life & Casualty while she was there. She is now the Director of the St. Louis Insurance Group and can be reached by email at