Medicare Part B Medical Insurance

Medicare Part B is the other half of Original Medicare. This plan will help you pay for medical services and a variety of mental health services. It may also help you cover the cost of some limited prescription drug medications.

Part B premiums
You pay a premium each month for Part B. Your Part B premium will be automatically deducted from your benefit payment if you get benefits from one of these:

• Social Security

• Railroad Retirement Board

• Office of Personnel Management

If you don’t get these benefit payments, you’ll get a bill.

Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.

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Part B Deductible & Co-insurance

After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amount for these:

• Most doctor services (including most doctor services while you’re a hospital inpatient)

• Outpatient therapy

• Durable Medical Equipment (DME)

Medicare Part B covers two types of services:

1. Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

2. Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Medicare Part B covers medically necessary services and preventive services that include, but are not limited to: 

• Clinical research

• Ambulance services

• Durable medical equipment (DME)

• Inpatient and outpatient care

• Partial hospitalization

• Limited outpatient prescription drugs and vaccinations

• Depression screenings

• Cardiovascular disease screenings

Remember, you pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Medicare Part B (Medical Insurance) covers:

• Abdominal aortic aneurysm screening

• Alcohol misuse screenings & counseling

• Bone mass measurements (bone density)

• Cardiovascular disease screenings

• Cardiovascular disease (behavioral therapy)

• Cervical & vaginal cancer screening

• Colorectal cancer screenings

• Multi-target stool DNA tests

• Screening barium enemas

• Screening colonoscopies

• Screening fecal occult blood tests

• Screening flexible sigmoidoscopies

• Depression screenings

• Diabetes screenings

• Diabetes self-management training

• Flu shots

• Glaucoma tests

• Hepatitis B shots

• Hepatitis B Virus (HBV) infection screening

• Hepatitis C screening test

• HIV screening

• Lung cancer screening

• Mammograms (screening)

• Nutrition therapy services

• Obesity screenings & counseling

• One-time “Welcome to Medicare” preventive visit

• Pneumococcal shots

• Prostate cancer screenings