Medicare Part B:  Medical Insurance

For more details on how Medicare Part B works please watch our video.

This is the second half of original Medicare. Part B helps to pay for care at a clinic or at a hospital as an outpatient including:

  • Physician services, including in the hospital
  • An annual wellness visit and preventive services, like flu shots and mammograms
  • Lab services, like blood tests
  • X-rays and some other diagnostic tests
  • Some health programs, like smoking cessation, obesity counseling and cardiac rehab
  • Physical therapy, occupational therapy and speech-language pathology services
  • Diabetes screenings, diabetes education and certain diabetes supplies
  • Mental health care
  • Durable medical equipment for use at home, like wheelchairs and walkers
  • Ambulatory surgery center services
  • Ambulance and emergency room services

Part B Costs

  • Premium
    • You will pay a monthly premium, currently $148.50.
    • Your premium is prorated by your income.  If your reported income from 2 years prior is above the designated level, you will pay a higher premium, as much as $504.90.
    • You are required to have Part B if you are 65 and don’t have health coverage through another source. 
    • If you have Medicare and Medi-Cal, Medi-Cal pays your premium.
  • Deductible
    • You have an annual deductible, which is $203 currently
  • Coinsurance
    • You generally pay 20% of the Medicare-approved amount for most covered services after you pay the deductible, with no annual out-of-pocket maximum. Medicare pays the remaining 80%. 

Enroll in Medicare Part B on time to avoid late enrollment penalties

The Part B penalty is 10% of the monthly premium amount for each full 12-month period enrollment is delayed.

You pay the penalty in addition to your premium for as long as you have Medicare Part B, unless you qualify for a Special Election Period or have a qualified plan. 

For example

If you delayed enrollment for 3 years, you will pay an additional 30% of the Part B premium as long as you have Part B.

Original Medicare (Parts A & B) does not cover:

  • Prescription drugs
  • Routine physicals
  • Routine dental, vision or hearing care
  • Eyeglasses, contacts and Hearing aids
  • Long-term or custodial care(help bathing, eating, dressing)
  • Excess charges for services by doctors who don’t accept Medicare assignment