What Does Medicare Part B Cover? A Comprehensive Guide to Understanding Benefits, Cost and Eligibility

Overview of Medicare Part B Coverage

Medicare Part B is a federal health insurance program that provides coverage for a range of medical services, including doctor visits, lab tests and preventive care. It’s available to individuals who are 65 or older, as well as people with certain disabilities. Understanding what Part B covers and the associated costs can help you make informed decisions about your healthcare.

Definition of Medicare Part B

Medicare Part B is a type of health insurance offered through the federal government. It helps pay for medically necessary services, such as doctor visits, preventive care and certain medical equipment. Part B also covers some mental health care and outpatient prescription drugs.

Who is Eligible for Medicare Part B

Most people who are over 65 and receiving Social Security benefits are automatically enrolled in Medicare Part B. People under 65 may be eligible if they have certain disabilities or end-stage renal disease. Individuals who are not eligible for Social Security benefits can apply directly for Part B coverage.

Explaining What Medicare Part B Covers

Medicare Part B covers a wide range of medical services, supplies and equipment. Here’s an overview of what it includes:

Outpatient Services

Part B covers a variety of outpatient services, including doctor visits, laboratory tests, X-rays, physical therapy and occupational therapy. It also covers ambulance services when medically necessary.

Preventative Care

Part B covers many types of preventive care, including annual wellness visits, flu shots and screenings for conditions like diabetes, cancer and high cholesterol. These services help you stay healthy and catch any potential problems before they become serious.

Medical Supplies and Equipment

Part B covers durable medical equipment, such as wheelchairs, walkers, crutches and hospital beds. It also covers certain medical supplies, such as oxygen tanks and blood sugar testing kits.

Mental Health Care

Part B covers mental health services, such as individual psychotherapy and group counseling. It also covers psychiatric medications prescribed by a doctor.

Common Services Covered by Medicare Part B

Part B covers a wide range of services, but here are some of the most common ones:

Doctor Visits

Part B covers doctor visits for routine checkups and medical problems. It also covers certain specialist visits, such as cardiologists, oncologists and neurologists.

Lab Tests

Part B covers laboratory tests, such as blood work, urine tests and genetic tests. It also covers tests like CT scans and MRIs.

X-Rays

Part B covers X-rays and other imaging tests, such as mammograms and ultrasounds.

Durable Medical Equipment

Part B covers durable medical equipment, such as wheelchairs, walkers, crutches and hospital beds.

Home Health Care

Part B covers home health care services, such as nursing care and physical therapy, when they are ordered by a doctor.

Cost of Medicare Part B Coverage

If you’re enrolled in Medicare Part B, you’ll be responsible for certain costs. Here’s an overview of what you can expect to pay:

Premiums

Most people pay a monthly premium for Part B coverage. The standard premium amount in 2021 is $148.50 per month, though some people may pay more or less depending on their income.

Deductibles

You’ll pay an annual deductible for Part B services. The standard deductible for 2021 is $203.

Copayments

After you meet your deductible, you’ll typically pay a copayment for Part B services. This can vary depending on the service. For example, you may pay 20% of the cost for doctor visits and lab tests.

How to Enroll in Medicare Part B

If you’re eligible for Medicare Part B, you can sign up during the Initial Enrollment Period. This period usually starts three months before you turn 65 and ends three months after. Alternatively, you can sign up during the General Enrollment Period, which runs from January 1 to March 31 each year.

When Can You Enroll?

The Initial Enrollment Period lasts seven months, starting three months before your 65th birthday and ending three months after. If you miss this window, you can sign up during the General Enrollment Period, which runs from January 1 to March 31 each year.

How to Sign Up

You can sign up for Medicare Part B online, by phone or in person. To enroll online, visit the Medicare website. To enroll by phone, call 1-800-MEDICARE (1-800-633-4227). To enroll in person, contact your local Social Security office.

Documents Needed to Enroll

When signing up for Medicare Part B, you’ll need to provide certain documents. These include proof of age, Social Security number and U.S. residency. You may also need to provide proof of disability if you’re applying due to a disability.

Medicare Part B is a federal health insurance program that provides coverage for a range of medical services, including doctor visits, laboratory tests and preventive care. Understanding what Part B covers and the associated costs can help you make informed decisions about your healthcare. Most people who are over 65 and receiving Social Security benefits are automatically enrolled in Part B. Others may be eligible if they have certain disabilities or end-stage renal disease. Part B covers a wide range of services, including doctor visits, lab tests, X-rays and durable medical equipment. It also pays for some mental health care and outpatient prescription drugs. If you’re enrolled in Part B, you’ll be responsible for certain costs, such as premiums, deductibles and copayments. You can sign up for Part B during the Initial Enrollment Period or the General Enrollment Period. When signing up, you’ll need to provide certain documents, such as proof of age and Social Security number.