MEDICARE PLANS

Medicare Part B

Medicare Part B is your MEDICAL INSURANCE under Original Medicare.

Medicare Part B is provided by the federal government and managed by the Centers for Medicare & Medicaid Services (CMS).

It helps cover:

  • Doctor visits
  • Outpatient care (like same-day surgeries or lab work)
  • Durable medical equipment (like wheelchairs or walkers)
  • Preventive services (like screenings, vaccines, and wellness visits)

Who is Eligible for Medicare Part B?

You are eligible for Medicare Part B if:

    • You are a U.S. citizen or legal permanent resident, and
    • You are 65 years old or older (or turning 65 soon)

You may also qualify under age 65 if you:

    • Have a qualifying disability, or
    • Have End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease)

How To Sign Up for Medicare Part B

Most people are enrolled automatically.
If you’re receiving Social Security or Railroad Retirement benefits, you’ll be automatically enrolled in Medicare Part B.

Your red, white, and blue Medicare card will arrive in the mail about 3 months before your 65th birthday.

Delaying Part B?
If you chose to delay Part B (for example, because you’re still working and have employer coverage), you can enroll later during a Special Enrollment Period (SEP) without a penalty.

To enroll during SEP, you’ll need to contact Social Security and submit the required forms.

Missed your initial chance?
If you didn’t sign up when first eligible and don’t qualify for SEP, you can enroll during the General Enrollment Period (GEP) from January 1 to March 31.

Your coverage will start the month after you enroll.

How Much Does Medicare Part B Cost?

Monthly Premium:
Most people pay the standard premium for Part B, which is $185 per month in 2025.

Income-Based Costs (IRMAA):
If your income is higher, you may pay more. This extra cost is called an Income-Related Monthly Adjustment Amount (IRMAA).

    • It’s based on your tax return from 2 years ago
    • The higher your income, the higher your monthly premium

Annual Deductible:
In 2025, the Part B deductible is $257.
After you meet this deductible, you’ll pay:

    • 20% of the cost for Medicare-approved services
    • Medicare covers the remaining 80%

This includes services like doctor visits, lab work, X-rays, and outpatient care.

What Does Medicare Part B COVER?

Medicare Part B helps pay for medical services and supplies that are necessary to treat or prevent health problems.

This includes:

  • Doctor visits (including specialists)
  • Outpatient care (like same-day surgeries or ER visits)
  • Lab tests and X-rays
  • Preventive services (like screenings, vaccines, and annual wellness visits)
  • Durable medical equipment (like wheelchairs, walkers, and oxygen)
  • Mental health services (outpatient therapy, depression screenings)
  • Ambulance services (when medically necessary)

What Medicare Part B Does NOT Cover?

  • Prescription drugs (you’ll need a separate Part D plan)
  • Routine dental care (like cleanings, fillings, or dentures)
  • Eye exams and eyeglasses
  • Hearing aids and exams for fitting them
  • Long-term care (like nursing home or custodial care)
  • Cosmetic surgery (unless medically necessary)