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Medicare Part B (Medical Coverage)

Coverage for Everyday Care and Outpatient Services

Medicare Part B helps cover the medical services you’re most likely to use, like doctor visits, outpatient care, lab tests, preventive screenings, and medications given in a clinical setting. It functions like traditional health insurance, but understanding how and when to enroll is key to avoiding penalties and unexpected costs.

What Medicare Part B Covers

From Doctor Visits to Diagnostic Tests

Part B pays for many of the essential services you need to stay healthy and manage conditions:

  • Doctor and specialist visits

  • Lab work and imaging (X-rays, MRIs, etc.)

  • Preventive services and screenings

  • Outpatient surgeries and rehab

  • Durable medical equipment (DME)

  • Certain medications administered in a doctor's office (like chemotherapy or infusion drugs)

Unlike Part A, which only applies when you’re admitted to a hospital, Part B is used for day-to-day healthcare needs. But it also comes with important cost-sharing rules you need to understand.

Cost and Enrollment

What You'll Pay and When to Enroll

If you’re already receiving Social Security, you’ll be automatically enrolled in Medicare Part A at age 65. If not, or if you don’t qualify based on your own work history, you may be eligible through a spouse—or you can apply manually through Social Security. Premiums are based on work history. Not sure what your premiums should be?

For most people, the standard Medicare Part B premium in 2025 is $202.90 per month. If your income is above a certain level, you may pay more under IRMAA (Income-Related Monthly Adjustment Amount).

Here’s how Part B costs break down:

  • Monthly Premium: $202.90

  • Annual deductible: $283.00

  • Medicare pays: 80% of approved charges

  • You pay: 20% of approved charges

  • Excess Charge: Providers MAY charge up to 15% more than Medicarfe allows

  • Part B drugs: Medicare pays 80%, and you pay 20% for drugs administered in a doctor's office

Important: Part B has no out-of-pocket maximum (MOOP)—meaning your costs can continue to add up unless you have supplemental coverage.

Client Services

Need a Medicare From

If you’re enrolling in Medicare Part A and B without taking Social Security, applying for Extra Help, requesting an IRMAA adjustment, or submitting employer coverage info, you may need official forms to get started.

How Part B Works With Other Coverage

Part B is just one part of your coverage. To protect yourself from major out-of-pocket expenses, you may also need:

  • Part A for hospital care

  • Part D for prescription drug coverage

  • A Medciare Supplement to help pay what Parts A and B don’t

  • OR a Medicare Advantage plan that combines everything into one

I’ll help you explore your options and find the right mix of coverage for your needs and budget.

Support You Can Count On

We offer annual Medicare plan reviews at no cost during Open Enrollment. It’s how we help you save money, stay ahead of coverage changes, and feel confident in your plan. There’s never a cost for our service, but real support, year after year.