What is Medicare Part B?

Learn all about what Medicare Part B is, what it covers, and how much it might cost you. Our overview of Medicare Part B answers all your questions in a short and concise way.
What is Medicare Part B?

Medicare Part B assists in paying for medical expenses not covered by Part A, such as doctor visits, outpatient care, and other services. Part B is not required. When medically necessary, Part B assists in covering the cost of covered medical services and supplies. A few preventative services, like as physicals, lab testing, and vaccinations to help discover, diagnose, or manage a medical issue are also covered in Part B.## What is Covered by Medicare Part BDoctor appointments, chiropractic visits, and some preventative services are all covered by Medicare Part B as being medically required for the diagnosis or treatment of an existing medical condition. Additionally, it covers treatments that are required for medical reasons, such as procedures for injuries or cataracts. This can also include:* Ambulance rides to a hospital or skilled nursing facility* Chiropractic services for lower back pain* Clinical research services (including drug trials)* Diabetes supplies* Emergency room services for injury or illness* Durable medical equipment, such as walkers and canes, oxygen equiptment, and beds* Mental health services, psychiatrist or specialist nurse practitioner visits* Health screenings for diabetes, bone density, and some cancers### Provider servicesServices that a qualified health practitioner provides to you that are medically required.### Durable medical equipmentIt is appropriate for use in the home, provides a medicinal purpose, and can survive repeated use. The use of wheelchairs, oxygen tanks, and walkers is only a few examples. After your provider certifies your need for it, you are able to buy or rent durable medical equipment from a company accepted by Medicare.### Home health servicesServices provided if you require specialized nursing or therapeutic care and are confined to your home.### Ambulance servicesTransportation for emergencies, usually to and from hospitals, is provided in this. Instances where there is no safe alternative form of transportation and where the transportation is medically required are the only ones in which non-emergency ambulance/ambulette transportation is covered.### Preventive servicesPreventive care is one of the best things you can do for your health, so take advantage of it. You can prevent disease or injury by routine exams, tests, vaccinations, and screenings, or you can detect it early and receive a better course of treatment. Many preventive healthcare services are covered by Original Medicare. The following is a list of preventative services covered by Medicare Part B. Keep in mind there may be certain restrictions or exclusions.### Shots* COVID* Flue* Hepatitis B ( for those at medium to high risk)* Pneumococcal### Exams* One-Time preventive visit (within the first 12 months of having Part B)* Yearly “Wellness” visits### Screenings* Abdominal aortic aneurysm (for people at risk)* Alcohol misuse (screening and counseling)* Bone mass measurement* Breast cancer (mammograms)* Cardiovascular disease* Cervical and vaginal cancer* Colorectal cancer* Depression* Diabetes (for people at risk)* Glaucoma (for people at high risk)* Hepatitis C (for certain ages and people at high risk)* HIV (for people at increased risk)* Pap test* Prostate cancer* Sexually transmitted infections (screening and counseling)### Other Preventive Benefits* Cardiovascular disease (intensive behavioral therapy)* Diabetes self-management training* Medical nutrition therapy (for people with diabetes or renal disease)* Obesity (intensive behavioral therapy)* Smoking and tobacco use cessation counseling## What Does Part B Not Cover?There are a few items or services not covered by original Medicare Part A, such as:* Routine physical examinations* Most prescription drugs* Dental care, including dentures* Most vision care, including eyeglasses or contact lenses* Hearing aids* routine foot care, unless related to health conditions such as diabetes, cancer, or chronic kidney disease* long-term care in nursing homes or in an assisted living facilities* medically unnecessary services, such as cosmetic surgery## What Does Part B Cost?A deductible, coinsurance, and premiums are all part of Medicare Part B. Regardless of the care or services you receive, you must pay the payments each month. Prior to Part B beginning to cover the majority of covered procedures, you must first pay your deductible out of pocket. Most medically required services covered by Part B require a 20% coinsurance payment from you, but most preventative care is free of cost.Higher yearly income earners could be required to pay higher monthly premiums. Your two-year-old tax return is used to calculate your yearly income. Who pays higher premiums because of income?Your monthly premium might increase by up to 10% of the normal premium for any 12-month period that you were eligible for Part B but didn't enroll. This is known as the "late enrollment penalty." As long as you have Part B coverage, you must pay this. Find out how the Part B penalty works and how to avoid it.### Part B PremiumThe typical Part B premium for 2022 amounts to $170.10 (or higher depending on your income). However, because of the "hold harmless" provision, about 3.5% of those who receive Social Security payments will pay less. The precise amount you'll pay will be provided by Social Security. Premium amounts usually change from year to year.> Note: Because of the "keep harmless" provision, certain beneficiaries of Social Security pay less. The actual amount you'll pay will be disclosed by Social Security.Beneficiaries who had a combined income of more than $182,000 (joint return) or $91,000 (individual return) in 2020 would pay a premium that ranges from $238.10 to $578.30, depending on their income.The table below lists the 2020 income levels.| Individual tax return (2020 income) | Individual tax return (2020 income) | Income-related monthly adjustment amount | Monthly Medicare Part B premium || --- | --- | --- | --- || $91,000 or less. | Less than or equal to $182,000 | $0.00 | $170.10 || Greater than $91,000 and less than or equal to $114,000 | Less than or equal to $182,000 | $68.00 | $238.10 || Greater than $114,000 and less than or equal to $142,000 |Greater than $228,000 and less than or equal to $284,000 |$170.00 |$340.20 || Greater than $142,000 and less than or equal to $170,000 |Greater than $228,000 and less than or equal to $284,000 |$272.20 |$442.30 || Greater than $170,000 and less than $500,000 |Greater than $228,000 and less than or equal to $284,000 |$374.20 |$544.30 || Greater than or equal to $500,000 |Greater than or equal to $750,000 |$408.20 |$578.30 |The following premiums apply to high-income beneficiaries who are married and and lived with their spouse at some point in the tax year but file a separate return:| Married & separate tax return (2020 income) | Income-related monthly adjustment amount | Monthly Medicare Part B premium || --- | --- | --- || Less than or equal to $91,000 | $0.00 | $170.10 || Greater than $91,000 and less than $409,000 | $374.20 | $544.30 || Greater than or equal to $409,000 | $408.20 | $578.30 |### Part B DeductibleFor the coverage year 2022, you will pay a $233 deductible once each year.### Part B coinsuranceYou normally pay 20% of the amount approved by Medicare for medical treatments and other Medicare benefits once your annual deductible has been met. Medicare Part B covers the remaining 80%. This is presuming that your physician or other healthcare practitioner accepts Medicare assignment. Some healthcare providers may charge patients the difference if their fees are higher than the cap set by Medicare. Always confirm that a new doctor or other healthcare professional accepts the portion that Medicare covers.Medicare Supplement Insurance, often known as Medigap, is frequently purchased by Original Medicare members to assist in covering the out-of-pocket expenses related to Medicare Part B. Read more about: What is Medigap?### Part B copayYou pay a predetermined amount known as a copay for a service. Copays are not usually connected to Part B. There are a few circumstances, though, in which you might have to pay for one. Anan example, using hospital outpatient services. In most cases, your copayment won’t be more than the Part A hospital stay deductible amount.---## What is Part C (Medicare Advantage)?Medicare Advantage (part C) is a Medicare health plan that includes Part A, Part B, and usually Part D. These plans are offered by a private company that is contracted with Medicare. These plans may offer extra benefits that Original Medicare doesn’t cover. This may include dental, vision, hearing, and prescription medication. Any copayments for primary care physician and specialist appointments, as well as for medications, are your responsibility. The cost varies based on your plan.You are typically limited to using doctors who are part of the plan's network.Before your plan will cover particular medications or services, you may have to obtain approval for it.Plans may have lower out-of-pocket costs than Original Medicare.Plans may provide additional benefits including vision, hearing, and dental care that Original Medicare does not.**Read more about Medicare Advantage:** [What is Medicare Advantage?](/medicare/basics/what-is-medicare-part-c-medicare-advantage)## What is Part D (Drug Coverage)?Prescription drug coverage under Medicare is referred to as Part D. It aids in paying for prescription drugs that are not covered by sections A or B. This prescription coverage is sold by private insurance companies so plans can vary and be priced differently. **Read more about:** [What is part D (Drug coverage)?](/medicare/basics/what-is-medicare-part-d-drug-coverage)