If you’re approaching 65 or helping a loved one prepare for Medicare, learning about Medicare Part B is an important step. While Medicare can
feel overwhelming at first, getting clear and simple information can make the process feel more manageable—and even empowering.
This post will gently walk you through what Medicare Part B covers, how much it costs, who needs it, and when to enroll. Our goal is to help you make informed decisions with confidence and peace of mind.
What Is Medicare Part B?
Medicare Part B is the part of Original Medicare that helps cover outpatient medical services .If Medicare Part A is hospital insurance, think of Part B as your doctor and medical insurance .
Together, Part A and Part B form the foundation of your Medicare
coverage.
What Does Medicare Part B Cover?
Medicare Part B helps pay for services that are medically necessary to diagnose or treat a condition, as well as many preventive services.
Common Services Covered:
- Doctor visits (primary care and specialists)
- Outpatient surgery and diagnostic tests
- Preventive screenings (e.g., mammograms, colonoscopies, diabetes screenings)
- Mental health outpatient services
- Durable medical equipment (like walkers or oxygen tanks)
- Ambulance services (emergency and some non-emergency)
- Limited home health care
It’s important to note that Medicare Part B does not cover :
- Prescription drugs (unless administered in a clinical setting)
- Most dental, vision, and hearing care
- Long-term or custodial care
How Much Does Medicare Part B Cost?
Premiums
Most people pay a monthly premium for Part B. In 2025, the standard Part B premium is $185.00 per month .
If your income is above a certain level, you may pay more due to IRMAA (Income-Related Monthly Adjustment Amount) .
Deductibles and Coinsurance
Annual deductible: $257 in 2025
After meeting your deductible, you typically pay 20% of the Medicare-approved amount for services and supplies
Unlike some employer health plans, Medicare Part B does not have an out-of-pocket maximum , which is why many people consider Medicare Supplement (Medigap) insurance to help with these costs.
Who Needs Medicare Part B?
Almost everyone becomes eligible for Medicare at age 65, but whether or not you need to enroll in Part B right away depends on your current situation.
You Should Enroll in Part B If:
- You’re retired or not covered by a creditable employer health plan
- Your employer has fewer than 20 employees
- You’re receiving Social Security benefits
You May Be Able to Delay If:
You or your spouse is actively working and covered by a group health plan from an employer with 20 or more employees
Delaying Part B without having creditable coverage can lead to late enrollment penalties that last for life.
When and How to Enroll in Part B
Your Initial Enrollment Period (IEP) is your first chance to sign up for Medicare:
- It lasts for 7 months, starting 3 months before your 65th birthday month, including your birthday month, and ending 3 months after .
If you’re not automatically enrolled, you can sign up:
- Online at ssa.gov/medicare
- By calling Social Security at 1-800-772-1213
- In person at your local Social Security office
If you delayed enrollment because you had creditable employer coverage, you can use a Special Enrollment Period (SEP) once that coverage ends.
How Part B Works with Other Medicare Options
Part B is just one piece of the puzzle. Once you have Part A and B, you
can choose to:
- Stay with Original Medicare and add:
- A Part D drug plan
- A Medicare Supplement (Medigap) plan
- Switch to a Medicare Advantage Plan (Part C) that bundles A, B and often D, along with extra benefits
Your decision will depend on your healthcare needs, budget, and preferred providers.
Final Thoughts: Medicare Part B Gives You Access to Everyday Care
While Medicare Part A covers you in the hospital, Medicare Part B gives you access to the care you need to stay healthy — from doctor visits to screenings and outpatient services. It’s an essential part of your Medicare
foundation.
Taking time to understand how Part B works—and how it fits with other Medicare options—will help you feel more prepared as you approach 65.
If you’re unsure about your next steps, you can:
- Visit Medicare.gov
- Speak with a licensed Medicare advisor
- Reach out to your State Health Insurance Assistance Program (SHIP) for free, unbiased help
Does Medicare Part B cover prescription Medications?
No, You will need a Part D Prescription Drug Plan.
Can I get my Part B premium lowered?
Yes, if you are paying more than the base amount and your income is
lower than 2 years prior you can submit a “Life Changing Event Form” and
get your Part B premium lowered.
Is the Deductible paid at every medical service?
No, the Part B deductible is an annual deductible and paid only once per
calendar year.
Mike Miligi- Owner
For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
