Medicare Part B

Medicare Part B covers outpatient healthcare services. This part of Original Medicare covers medically necessary services and supplies. Flu shots, colonoscopies, mammograms, and wellness checkups are examples of what is included in these outpatient services. It also covers routine outpatient services such as doctor’s visits, lab work, and home health.

Original Medicare Part B covers services that are often expensive. Chemotherapy or radiation would fall under this part. Part B will also pay for drugs given to you in a medical clinic, such as injections for osteoporosis, infusion drugs, and insulin that is used with an insulin pump.

More expensive services that occur in the hospital could also be covered under this part. Including radiation or chemotherapy for cancer, surgeries, diagnostic imaging, medical equipment, and dialysis for failing kidneys.

Medicare Part B

What is your cost for Medicare Part B?

A monthly premium is required to receive benefits of Medicare Part B. Most people will pay $185 per month to enroll. This amount is set by the government, and it is based on your income. You may pay more for your Part B if your income falls above a certain level. An income bracket can be found by clicking on Medicare Part B/IRMAA.

What is the process to enroll?

Your enrollment into Medicare Part B is automatic if you are receiving Social Security benefits. Your Medicare card will be mailed to you 2-3 months prior to your 65th birthday. If you are not receiving Social Security Benefits, you can enroll one of the following three ways:

If you are already receiving Social Security benefits, Medicare will deduct your Part B premiums from your check. Accordingly, if you are not receiving benefits, you will be billed quarterly.

What are your costs for medical care under Medicare Part B?

The Part B deductible for 2025 is $257. After you pay the $257 deductible, Medicare pays 80% of the cost. You are then responsible for the remaining 20%. One very important thing to remember is that your 20% has NO limits or caps.

The 20% that you will owe for your outpatient care can become very expensive. Medical services like surgeries or chemotherapy can add up to thousands of dollars. Remember, as stated earlier, there is no limit or cap on what your 20% could total.

There is no reason why you should have to pay these costly claims and expenses when there are supplemental coverage options available. Purchasing a Medicare supplement (Medigap) plan could limit out of pocket expenses to almost zero.

What is the Medicare Part B Late Enrollment Penalty?

You could be required to pay a late enrollment penalty if you did not sign up for Part B during your initial enrollment period. This penalty will be lifelong once you sign up for it. The penalty is 10% for each year that you delay enrollment.

If you enrolled late due to complications with an employer group health coverage from a company with 20 or more employees, you will not be subject to the Medicare Part B late enrollment penalty. When you leave that coverage, you have 8 months to sign up for Medicare Part B. This enrollment period is called your Special Enrollment Period for Medicare.

The best way to avoid the Medicare Part B late enrollment penalty is to enroll in Medicare during your Initial Enrollment Period. You can learn more about late enrollment by clicking here.

Do I need to enroll Medicare Part B if I am still working?

The answer to this question depends on the type of insurance that you have. If you have Cobra or an individual policy, then you would need to enroll in Medicare Part B. If your insurance is through current employment of either you or your spouse with a large employer (20 or more employees), then you DO NOT have to enroll in Medicare Part B.

Working Past 65

You can defer your enrollment, because you have “creditable coverage.” Your creditable coverage through you or your spouse’s employer will serve as your coverage until you or your spouse decide to retire.

When this coverage ends, Medicare provides special periods to enroll in Part B. You will have 8 months to sign up for your Part B. This is known as your Special Enrollment Period. Many individuals that are working past 65 years of age and have creditable coverage through their employer are deferring Part B.

You can still enroll in Medicare Part A without having to sign up for Medicare Part B. By deferring Part B, you are saving yourself the monthly premiums that you would be assessed for enrolling in Part B.

Still have questions about your coverage? Call today for free consultation. Or, click here to get a quote on your Medicare options!