MedicareOptions360.com

A trusted, non-government site

Find Medicare Plans & Rates In Your Area

Find Medicare Plans & Rates In Your Area

Find Medicare Plans & Rates In Your Area

Updated on 4/12/2024

Medicare Part B

Updated on 4/12/2024

Medicare Part B

Updated on 4/12/2024

Medicare Part B

If you’re becoming Medicare eligible, like many people you’re probably being inundated by a flood of Medicare and Social Security information. You most likely have received notices from Social Security and other organizations regarding Medicare and are confused about Part A, Part B and Part D; let alone trying to make a decision about Medigap or Medicare Advantage. Here we take a look at Medicare Part B - what it covers and what it costs – and then we’ll walk you through the sign up process. For a quick overview on all the parts of Medicare, please visit our Medicare 101 page.


What is Medicare Part B and do I need it?


Medicare Part B is what is known as your medical insurance. It helps cover medically necessary services such as doctor office visits, inpatient and outpatient surgeries and procedures, lab work and x-rays, complex diagnostic imaging (e.g.: CT, PET, MRI scans, etc.), radiation therapy and chemotherapy, durable medical equipment (e.g.: wheel chairs, oxygen tanks, etc.), diabetic supplies, home health services, ambulance, and other medical services. Part B also helps cover preventive services such as screenings (e.g.: cardiovascular disease, colorectal cancer, cervical cancer, diabetes, mammograms, prostate cancer, etc.) and annual wellness visits. 


What costs are associated with Part B?


Part B Premium


Most people new to Medicare in 2024 will pay the standard Part B monthly premium of $174.70. 


Lower income people:

People who qualify due to low income may have their Part B premiums paid by their state Medicaid program (here in California it’s called “Med-Cal”). To see if you qualify, please call Social Security at:(800) 772-1213 or your state Medicaid program.


Higher income people:

Those who file individual tax returns with an annual income greater than $103,000, and those filing jointly with an annual income greater than $206,000 may pay an additional surcharge on top of the standard Part B monthly premium. Medicare calls this surcharge an “Income Related Monthly Adjustment Amount (“IRMAA”). If you have questions regarding the Part B IRMAA surcharge, please give us a call at (877) 888-6315 or you can Contact Us here for further assistance.


Part B Cost Sharing (what you are responsible for)


In 2024, the Part B deductible is $240. Once your Part B deductible is met, you will be responsible for 20% of Medicare approved services associated with Part B (this is known as your Part B 20% co-insurance). It is important to note that there is no limit to the 20% you are responsible for. 


Preventive services are covered at no cost to you.


When should I sign up for Part B?


At age 65, you have a 7 month window to apply for Part B which begins 3 months before your 65th birthday, the month of your 65th birthday, and 3 months after your 65th birthday. You can also sign up for Medicare Part B at any time while you’re still covered by an employer or union group health plan or during the 8 months after your employer or union group health plan ends.


What if I don’t sign up for Part B?


If you do not sign up for Part B during any of the above periods you may end up having to pay a Part B Late Enrollment Penalty – which is up to 10% of the Part B premium for each 12 month period you did not have it. You can then only sign up for Part B during the General Enrollment Period which happens Jan. 1st to March 31st and your Part B coverage will not take effect until July 1st. 


If you are employed and have health insurance through your employer, you can wait to sign up for Part B until you are no longer working. In this case you will not incur a Part B Late Enrollment Penalty and you can sign up for Part B at any time as long as you have proof that you have/had health insurance through your employer. Once you stop working you will have an 8 month window to sign up for Part B that starts the month after your employment ends (this is called a “Special Enrollment Period”). 


 *NOTE: COBRA is not considered employer based health insurance. If you opt for COBRA instead of enrolling in Medicare, you will not be eligible for a Special Enrollment Period to sign up for Part B once your COBRA coverage ends.   


Signing up for Part B


If you are already drawing Social Security benefits before age 65 you will be automatically enrolled in Part B. If you are waiting to draw Social Security benefits until on or after age 65 you will have to sign up for Part B manually. For those just turning 65, the easiest way to sign up for Part B is through the Social Security website: https://www.ssa.gov/benefits/medicare/. It’s a fairly straightforward process and will probably only take 15 – 20 minutes assuming you know all of the personal information they will be asking. 


Signing up for Part B after age 65


If you or your spouse have been working past age 65 and have been covered under employer or union group health insurance, signing up for Part B through the Social Security website will not be possible. In this case, your best bet is to go down to any Social Security office and sign up in person. The reason is because you will need to show proof that you’ve had “creditable coverage”, a term that means “as good as or better than Medicare”, since you turned 65. To demonstrate proof, you will need to take a “Request For Employment Information” form (found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf ) to your employer (or spouse's employer) and have them fill out Section B. You will need to fill out section A and then bring the completed form with you to your appointment with Social Security. Some Social Security offices are extremely busy and are booking appointments up to 6 – 8 weeks in advance. Other offices are not busy at all and will take you as a walk-in appointment. You will definitely want to call ahead so you know what to expect. To find Social Security offices near you click here: https://www.ssa.gov/locator/


Things to consider


Because the Part B co-insurance (the portion you are responsible for) has no limit, your out of pocket expenses for things like surgeries, tests (including diagnostic radiology), chemotherapy, and other treatments that fall under Part B, could potentially become astronomical. To limit your financial exposure to costly medical expenses, consider enrolling in either a Medicare supplement plan or Medicare Advantage plan.

If you’re becoming Medicare eligible, like many people you’re probably being inundated by a flood of Medicare and Social Security information. You most likely have received notices from Social Security and other organizations regarding Medicare and are confused about Part A, Part B and Part D; let alone trying to make a decision about Medigap or Medicare Advantage. Here we take a look at Medicare Part B - what it covers and what it costs – and then we’ll walk you through the sign up process. For a quick overview on all the parts of Medicare, please visit our Medicare 101 page.


What is Medicare Part B and do I need it?


Medicare Part B is what is known as your medical insurance. It helps cover medically necessary services such as doctor office visits, inpatient and outpatient surgeries and procedures, lab work and x-rays, complex diagnostic imaging (e.g.: CT, PET, MRI scans, etc.), radiation therapy and chemotherapy, durable medical equipment (e.g.: wheel chairs, oxygen tanks, etc.), diabetic supplies, home health services, ambulance, and other medical services. Part B also helps cover preventive services such as screenings (e.g.: cardiovascular disease, colorectal cancer, cervical cancer, diabetes, mammograms, prostate cancer, etc.) and annual wellness visits. 


What costs are associated with Part B?


Part B Premium


Most people new to Medicare in 2024 will pay the standard Part B monthly premium of $174.70. 


Lower income people:

People who qualify due to low income may have their Part B premiums paid by their state Medicaid program (here in California it’s called “Med-Cal”). To see if you qualify, please call Social Security at:(800) 772-1213 or your state Medicaid program.


Higher income people:

Those who file individual tax returns with an annual income greater than $103,000, and those filing jointly with an annual income greater than $206,000 may pay an additional surcharge on top of the standard Part B monthly premium. Medicare calls this surcharge an “Income Related Monthly Adjustment Amount (“IRMAA”). If you have questions regarding the Part B IRMAA surcharge, please give us a call at (877) 888-6315 or you can Contact Us here for further assistance.


Part B Cost Sharing (what you are responsible for)


In 2024, the Part B deductible is $240. Once your Part B deductible is met, you will be responsible for 20% of Medicare approved services associated with Part B (this is known as your Part B 20% co-insurance). It is important to note that there is no limit to the 20% you are responsible for. 


Preventive services are covered at no cost to you.


When should I sign up for Part B?


At age 65, you have a 7 month window to apply for Part B which begins 3 months before your 65th birthday, the month of your 65th birthday, and 3 months after your 65th birthday. You can also sign up for Medicare Part B at any time while you’re still covered by an employer or union group health plan or during the 8 months after your employer or union group health plan ends.


What if I don’t sign up for Part B?


If you do not sign up for Part B during any of the above periods you may end up having to pay a Part B Late Enrollment Penalty – which is up to 10% of the Part B premium for each 12 month period you did not have it. You can then only sign up for Part B during the General Enrollment Period which happens Jan. 1st to March 31st and your Part B coverage will not take effect until July 1st. 


If you are employed and have health insurance through your employer, you can wait to sign up for Part B until you are no longer working. In this case you will not incur a Part B Late Enrollment Penalty and you can sign up for Part B at any time as long as you have proof that you have/had health insurance through your employer. Once you stop working you will have an 8 month window to sign up for Part B that starts the month after your employment ends (this is called a “Special Enrollment Period”). 


 *NOTE: COBRA is not considered employer based health insurance. If you opt for COBRA instead of enrolling in Medicare, you will not be eligible for a Special Enrollment Period to sign up for Part B once your COBRA coverage ends.   


Signing up for Part B


If you are already drawing Social Security benefits before age 65 you will be automatically enrolled in Part B. If you are waiting to draw Social Security benefits until on or after age 65 you will have to sign up for Part B manually. For those just turning 65, the easiest way to sign up for Part B is through the Social Security website: https://www.ssa.gov/benefits/medicare/. It’s a fairly straightforward process and will probably only take 15 – 20 minutes assuming you know all of the personal information they will be asking. 


Signing up for Part B after age 65


If you or your spouse have been working past age 65 and have been covered under employer or union group health insurance, signing up for Part B through the Social Security website will not be possible. In this case, your best bet is to go down to any Social Security office and sign up in person. The reason is because you will need to show proof that you’ve had “creditable coverage”, a term that means “as good as or better than Medicare”, since you turned 65. To demonstrate proof, you will need to take a “Request For Employment Information” form (found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf ) to your employer (or spouse's employer) and have them fill out Section B. You will need to fill out section A and then bring the completed form with you to your appointment with Social Security. Some Social Security offices are extremely busy and are booking appointments up to 6 – 8 weeks in advance. Other offices are not busy at all and will take you as a walk-in appointment. You will definitely want to call ahead so you know what to expect. To find Social Security offices near you click here: https://www.ssa.gov/locator/


Things to consider


Because the Part B co-insurance (the portion you are responsible for) has no limit, your out of pocket expenses for things like surgeries, tests (including diagnostic radiology), chemotherapy, and other treatments that fall under Part B, could potentially become astronomical. To limit your financial exposure to costly medical expenses, consider enrolling in either a Medicare supplement plan or Medicare Advantage plan.

If you’re becoming Medicare eligible, like many people you’re probably being inundated by a flood of Medicare and Social Security information. You most likely have received notices from Social Security and other organizations regarding Medicare and are confused about Part A, Part B and Part D; let alone trying to make a decision about Medigap or Medicare Advantage. Here we take a look at Medicare Part B - what it covers and what it costs – and then we’ll walk you through the sign up process. For a quick overview on all the parts of Medicare, please visit our Medicare 101 page.


What is Medicare Part B and do I need it?


Medicare Part B is what is known as your medical insurance. It helps cover medically necessary services such as doctor office visits, inpatient and outpatient surgeries and procedures, lab work and x-rays, complex diagnostic imaging (e.g.: CT, PET, MRI scans, etc.), radiation therapy and chemotherapy, durable medical equipment (e.g.: wheel chairs, oxygen tanks, etc.), diabetic supplies, home health services, ambulance, and other medical services. Part B also helps cover preventive services such as screenings (e.g.: cardiovascular disease, colorectal cancer, cervical cancer, diabetes, mammograms, prostate cancer, etc.) and annual wellness visits. 


What costs are associated with Part B?


Part B Premium


Most people new to Medicare in 2024 will pay the standard Part B monthly premium of $174.70. 


Lower income people:

People who qualify due to low income may have their Part B premiums paid by their state Medicaid program (here in California it’s called “Med-Cal”). To see if you qualify, please call Social Security at: (800) 772-1213 or your state Medicaid program.


Higher income people:

Those who file individual tax returns with an annual income greater than $103,000, and those filing jointly with an annual income greater than $206,000 may pay an additional surcharge on top of the standard Part B monthly premium. Medicare calls this surcharge an “Income Related Monthly Adjustment Amount (“IRMAA”). If you have questions regarding the Part B IRMAA surcharge, please give us a call at (877) 888-6315 or you can Contact Us  here  for further assistance.


Part B Cost Sharing (what you are responsible for)


In 2024, the Part B deductible is $240. Once your Part B deductible is met, you will be responsible for 20% of Medicare approved services associated with Part B (this is known as your Part B 20% co-insurance). It is important to note that there is no limit to the 20% you are responsible for. 


Preventive services are covered at no cost to you.


When should I sign up for Part B?


At age 65, you have a 7 month window to apply for Part B which begins 3 months before your 65th birthday, the month of your 65th birthday, and 3 months after your 65th birthday. You can also sign up for Medicare Part B at any time while you’re still covered by an employer or union group health plan or during the 8 months after your employer or union group health plan ends.


What if I don’t sign up for Part B?


If you do not sign up for Part B during any of the above periods you may end up having to pay a Part B Late Enrollment Penalty – which is up to 10% of the Part B premium for each 12 month period you did not have it. You can then only sign up for Part B during the General Enrollment Period which happens Jan. 1st to March 31st and your Part B coverage will not take effect until July 1st. 


If you are employed and have health insurance through your employer, you can wait to sign up for Part B until you are no longer working. In this case you will not incur a Part B Late Enrollment Penalty and you can sign up for Part B at any time as long as you have proof that you have/had health insurance through your employer. Once you stop working you will have an 8 month window to sign up for Part B that starts the month after your employment ends (this is called a “Special Enrollment Period”). 


 *NOTE: COBRA is not considered employer based health insurance. If you opt for COBRA instead of enrolling in Medicare, you will not be eligible for a Special Enrollment Period to sign up for Part B once your COBRA coverage ends.   


Signing up for Part B


If you are already drawing Social Security benefits before age 65 you will be automatically enrolled in Part B. If you are waiting to draw Social Security benefits until on or after age 65 you will have to sign up for Part B manually. For those just turning 65, the easiest way to sign up for Part B is through the Social Security website: https://www.ssa.gov/benefits/medicare/. It’s a fairly straightforward process and will probably only take 15 – 20 minutes assuming you know all of the personal information they will be asking. 


Signing up for Part B after age 65


If you or your spouse have been working past age 65 and have been covered under employer or union group health insurance, signing up for Part B through the Social Security website will not be possible. In this case, your best bet is to go down to any Social Security office and sign up in person. The reason is because you will need to show proof that you’ve had “creditable coverage”, a term that means “as good as or better than Medicare”, since you turned 65. To demonstrate proof, you will need to take a “Request For Employment Information” form (found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf ) to your employer (or spouse's employer) and have them fill out Section B. You will need to fill out section A and then bring the completed form with you to your appointment with Social Security. Some Social Security offices are extremely busy and are booking appointments up to 6 – 8 weeks in advance. Other offices are not busy at all and will take you as a walk-in appointment. You will definitely want to call ahead so you know what to expect. To find Social Security offices near you click here: https://www.ssa.gov/locator/


Things to consider


Because the Part B co-insurance (the portion you are responsible for) has no limit, your out of pocket expenses for things like surgeries, tests (including diagnostic radiology), chemotherapy, and other treatments that fall under Part B, could potentially become astronomical. To limit your financial exposure to costly medical expenses, consider enrolling in either a Medicare supplement plan or Medicare Advantage plan.

Have Questions?

We’re here to help guide you through the Medicare Maze!

Call now: (877) 888-6315 

Or Contact Us here. It's free and there's never any obligation!

Have Questions?

We’re here to help guide you through the Medicare Maze!

Call now: (877) 888-6315 

Or Contact Us here. It's free and there's never any obligation!

Have Questions?

We’re here to help guide you through the Medicare Maze!

Call now: (877) 888-6315 

Or Contact Us here. It's free and there's never any obligation!

Share by: