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What is Medicare Part B?

What is Medicare Part B?

| September 14, 2022
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Medicare Part B is your medical insurance typically administered at a doctor's office or outpatient facility. 

 

What is it?  

It is government-mandated medical insurance that helps pay for services rendered outside a hospital. This insurance helps pay for doctor visits, outpatient care, durable medical equipment, ambulance services, clinical research, some mental health services, and limited outpatient prescription drugs administered in the doctor’s office. 

It’s intended to cover two types of services. The first is medically necessary services or supplies necessary to diagnose and treat your medical condition. They must also meet the accepted standards of medical practice. The second is health care to prevent illness or detect an early stage, where early treatment is likely to be most effective. 

 

Who is eligible

Medicare Part B is health insurance for people aged 65 or older, certain people under 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD). 

 

When can I sign up? 

You have an Initial Enrollment Period (IEP) which is a seven-month window around the month you turn 65 to first sign up for Medicare. This seven-month period consists of the three months before your birth month, your birthday month and three months following your birth month. I discussed this in depth in a previous post.  

In 2022, your effective date or coverage start date is the month you turn 65 if you sign up one to three months before you turn 65. If you elect to sign up the month you turn 65, then your effective date is the following month. The same holds true for all three months that follow. Your coverage would begin the following month after signing up.  

 

Should I sign up for it?  

If you choose not to sign up for Medicare Part B, and decide to do so later, your coverage could be delayed. You may have to pay a higher monthly premium for as long as you have Part B. Your monthly premium will go up by a 10% late-enrollment penalty for each 12-month period you were eligible for Part B but did not sign up for it. 

 

How is your care paid?  

Part B has an annual deductible that changes annually. The deductible for 2022 is $233. After you have satisfied that requirement, Part B becomes a cost share plan where Medicare pays 80% and you are responsible for 20%. 

 

What is the monthly premium? 

Medicare Part B has a monthly premium. The premium amount typically changes annually and is based on your modified adjusted gross income as reported on your tax return from two years prior, also referred to as a 2-year lookback. Every year they process a 2-year lookback to calculate your current premium. For 2022, they will use your 2020 tax returns as the basis. The standard premium for 2022 is $170.10. Depending on your level of income, an income-related monthly adjustment amount (IRMAA) may be imposed. See the chart below to see what your Part B premiums will be. 

If your yearly income in 2020 was: 

File Individual Return 

File Joint tax return 

File married & separate tax return 

You pay (in 2022) 

$91,000 or less 

$182,000 or less 

$91,000 or less 

$170.10 

>$91,000 - $114,000 

>$182,000-$228,000 

Not applicable  

$238.10 

>$114,000- $142,000 

>$228,000-$284,000 

Not applicable 

$340.20 

>$142,000 - $170,000 

>$284,000-$340,000 

Not applicable 

$442.30 

>$170,000- $499,999 

>$340,000-$749,999 

>$91,000 and <$409,000 

$544.30 

>$500,000 

>$750,000 

>$409,000 

$578.30 

 

*Some inclusions or exclusions may apply. If you are unsure about coverage, unable to enroll or disenroll into Medicare or just need help please contact one of our agents or your local Center for Medicare & Medicaid Services.  

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