What is Medicare Part B?

Medicare, a health insurance program for those who are age 65 and over, as well as for those who have certain qualifying disabilities and end stage renal disease (ESRD), is administered by the United States federal government. This program has four components, which encompass coverage for hospitalization, doctors’ and medical services, and prescription drug expenses.

What Does Medicare Part B Cover?

Medicare Part B covers doctors’ and medical services. This part of Medicare provides coverage for two types of services. These include medically necessary services such as those that are required for diagnosing or treating a medical condition and that meet the accepted standards of medical practice, as well as various preventive health care service that helps either in preventing illnesses or with detecting illness at an early stage when treatment is the most likely to work.

Medicare Part B helps enrollees to cover expenses in the following areas:

  • Services from doctors and other types of health care providers
  • Outpatient care services
  • Home health care costs
  • Durable medical equipment
  • Some preventive care services

Some of the items that Medicare Part B covers may include clinical research, ambulance services, obtaining a second opinion prior to surgery, mental health services, and limited outpatient prescription drugs.

How Much Does Medicare Part B Cost?

Unlike Medicare Part A, enrollees in Medicare Part B are required to pay a monthly premium. For many participants, the Part B monthly premium in 2014 is $104.90. However, the premium that you pay is determined by your modified adjusted gross income that was reported on your IRS tax return from two years ago. If that income was above a certain amount, you will be required to pay more.

Medicare Part B Premiums By Income

Individual Tax Return in 2012 Joint Tax Return in 2012 File Married & Separate Tax Return in 2012 Medicare Part B Premium in 2014 (per month)
$85,000 or less $170,000 or less $85,000 or less $104.90
Above $85,000 up to $107,000 Above $170,000 up to $214,000 Not applicable $146.90
Above $107,000 up to $160,000 Above $214,000 up to $320,000 Not applicable $209.80
Above $160,000 up to $214,000 Above $320,000 up to $428,000 Above $85,000 and up to $129,000 $272.70
Above $214,000 Above $428,000 Above $129,000 $335.70

Who Qualifies for Medicare Part B?

Some people will automatically qualify for Medicare Part B. If you are already receiving retirement benefits from Social Security, then you will automatically be enrolled in Medicare Part B starting the first day of the month in which you turn age 65. If your birthday is on the first day of the month, then your benefits will begin on the first day of the previous month.

If you are disabled and you are under the age of 65, you will automatically receive Medicare Part B after you have been receiving disability benefits from Social Security for 24 months or you have been receiving certain disability benefits from the Railroad Retirement Board for 24 months.

How Do You Apply for Medicare Part B?

If you are close to age 65 and you want to enroll in Medicare Part B, you will need to apply for coverage. In order to do so, you should contact the Social Security Administration approximately three months prior to your 65th birthday. You can also apply for your Medicare Part B coverage by going to the Social Security website.

If you have End Stage Renal Disease, you will also need to contact Social Security in order to determine how and when to apply for Medicare Part B. For those who live in Puerto Rico and are eligible for Medicare Part B, you will need to contact your local Social Security Office in order to apply.

In any case, if you do not sign up for Medicare Part B when you are initially eligible for benefits, it is possible that you may have to pay a late enrollment penalty for as long as you have your Medicare Part B coverage.


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