When you first enroll in Medicare, you’ll enroll in Parts A and B, which make up Original Medicare. Part B is your medical, or outpatient, insurance, and has a monthly premium of $164.90 in 2023. If you’re still working, you may be able to delay your Part B enrollment without risk of penalty (more on this later). Once you have enrolled in both Part A and Part B, you’re able to explore additional Medicare insurance options, like Medigap, Medicare Advantage, and prescription drug coverage (Part D).
Below, you’ll find information on Part B coverage, cost, enrollment process, and penalties.
Medicare Part B is medical, or outpatient, insurance. It covers a wide range of medically necessary services and supplies required to prevent, diagnose, or treat various medical conditions. Part B is available to Americans who meet Medicare’s age or disability requirements. Below is a list of the most common services Part B covers:
Understanding the coverage provided by Medicare Part B can help you access essential medical services and supplies.
To secure Part B coverage, you’ll need to pay a monthly premium. In 2023, the standard Part B Premium that most retirees pay is $164.90.
If your income is above a certain amount, you'll pay an income-related monthly adjustment amount (IRMAA) in addition to your Part B premium. Learn more about IRMAA for Part B and Part D.
An annual deductible must also be met before Medicare Part B pays its share. After you meet the deductible, you’re generally responsible for paying a coinsurance or copayment amount for the covered services. The deductible for Part B in 2023 is $226.
Once you meet the deductible, Part B covers 80% of the cost of covered services, and you are responsible for the remaining 20%. This is known as coinsurance. There may also be copays for certain services, such as doctor visits. For this reason, it’s worth considering additional Medicare insurance options (Medigap, Medicare Advantage, and prescription drug plans) to control your out-of-pocket costs.
When to enroll is dependent on your situation.
Something to consider is that if you delay Part B enrollment and are not eligible for a Special Enrollment Period, you may experience gaps in coverage and have to pay late enrollment penalties. The penalty is 10% of your monthly premium for every year you’ve waited to enroll – and that’s on top of your monthly premium! To avoid this penalty, make sure you’re aware of when your IEP is and if you qualify for Special Enrollment.
Keeping track of all of the different parts of Medicare and finding what’s best for you can feel overwhelming. We’re here to help! If you have questions or want assistance with your Medicare decisions, don’t hesitate to reach out to one of our licensed Advisors!