Medicare Part B: Cost, Coverage, and Eligibility (2025 Guide)
Medicare Part B helps seniors 65 and older pay for doctor visits, preventive services, and medical equipment. The monthly Part B premium is $185, but there are savings programs for eligible seniors. Compare options like Medicare Advantage or Medigap plans to find affordable Medicare Part B coverage.
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Michelle Robbins
Licensed Insurance Agent
Michelle Robbins has been a licensed insurance agent for over 13 years. Her career began in the real estate industry, supporting local realtors with Title Insurance. After several years, Michelle shifted to real estate home warranty insurance, where she managed a territory of over 100 miles of real estate professionals. Later, Agent Robbins obtained more licensing and experience serving families a...
Licensed Insurance Agent
UPDATED: Aug 18, 2025
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We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
UPDATED: Aug 18, 2025
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes should be easy. This doesn’t influence our content. Our opinions are our own.
On This Page
Medicare Part B covers medical insurance costs for seniors 65 and older. It pays for 80% of outpatient services, including doctor visits, medical equipment, and home healthcare.
It’s part of Original Medicare, but unlike Part A, Medicare Part B is not free — premiums are $185 per month (Learn More: Medicare Advantage vs. Original Medicare). Beneficiaries must also meet a deductible and pay any copays or coinsurance costs associated with their plan.
- Seniors turning 65 have about 18 months to sign up for Medicare Part B
- The Medicare Part B premium is the same for all beneficiaries at $185 a month
- Medicare Advantage and Medigap plans can help cover Medicare Part B costs
Use this guide to compare Medicare costs and learn how you can avoid paying for Medicare Part B. If you still have questions, call (855) 634-0435 to speak with a licensed insurance agent about your Medicare needs.
Medicare Part B Premiums & Costs
How much will Medicare Part B premiums be this year? Beneficiaries pay $185 a month for Medicare Part B coverage, but Social Security benefits can often cover some or all of your premium.
Medicare Copay, Coinsurance, & Premium Cost Breakdown| Feature | Copay | Coinsurance | Premium |
|---|---|---|---|
| Definition | A fixed dollar amount you pay for a covered service or prescription | A percentage of the total cost you pay after meeting your deductible | A monthly amount you pay to maintain Medicare coverage |
| When Charged | At the time of service or prescription refill | After you’ve met your deductible | Monthly, regardless of whether you use services |
| Medicare Parts | Part C (Medicare Advantage), Part D (Prescription Drug Plans) | Part A (Hospital), Part B (Medical), and some Part D drug tiers | Part A (if applicable), Part B, Part C, and Part D |
| Typical Cost | $25 for a doctor visit | 20% of the cost of a $1,000 outpatient service equals $200 | $185 per month for Part B |
| Cost Predictability | More predictable; set amount regardless of service price | Varies based on the cost of the service | Very predictable; the amount is fixed each month |
| Varies by Plan | Yes, based on your Medicare Advantage or Part D plan | Yes, especially in Advantage plans or specialty services | Yes, based on Medicare Part and your income level |
Beneficiaries are also responsible for 20% copay and coinsurance payments to compensate for what Medicare Part B doesn’t cover. Can you get Medicare Part B for free? Some beneficiaries are eligible. Find out how to qualify in our guide on how much Medicare costs.
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What Medicare Part B Covers
Medicare Part B is the medical insurance part of Original Medicare plans. It partially covers visits to your doctor, outpatient hospital services, and care from other licensed healthcare providers, including mental health and substance abuse specialists.
It also pays for durable medical equipment (DME), such as wheelchairs, canes and walkers, hospital beds, oxygen equipment, and blood sugar monitors.
In some cases, Part B will cover certain outpatient prescription drugs associated with DME. Screenings and annual vaccines are also covered by Medicare Part B.
Read More: Best Endocrinologists That Accept Medicare
What Part B Doesn’t Cover
Medicare Part B handles most of your outpatient care needs, like routine appointments and preventative care, but it doesn’t cover all of your health insurance needs.
It won’t pay for routine dental, vision, or hearing care, and it doesn’t cover prescription drugs or hospital stays. Many of these things are covered by other types of Medicare insurance plans.
Medicare Part B Exclusions
Exclusions Reason
Inpatient Hospital Care Covered under Medicare Part A
Long-Term Care Not medically necessary by Medicare standards
Prescription Drugs Covered under Medicare Part D, not Part B
Dental, Vision, Hearing Only covered if part of Medicare Advantage (not Part B)
Care Outside the U.S. Medicare generally doesn’t cover services abroad
If you need these additional coverages, compare Medicare Advantage or Medicare Supplemental Insurance (Medigap) plans to find the right Medicare Part B provider for you.
Using Medicare Part B
More than half of seniors use Medicare Part B to pay for outpatient care after surgery, routine doctor visits, and preventative care like vaccines and disease management. Learn more about how to pay for what your health insurance won’t cover.
Do I need Medicare Part B if I have insurance? Not necessarily, especially if you are still employed and insured under a group health plan, since Medicare charges more for out-of-network providers than other insurers.
Medicare Part B Pros & Cons
Feature Pros Cons
Outpatient Coverage Covers doctor visits and outpatient care Doesn’t cover everything
Provider Access Widely accepted by providers Higher cost if not Medicare-approved
Enrollment Special sign-up periods if covered elsewhere Late sign-up may lead to penalty
Plan Coordination Works with other Medicare plans May need more plans for full coverage
Costs Lowers some out-of-pocket costs Still has ongoing expenses
However, health insurance costs increase with age, and Medicare Part B is typically more affordable than standard health plans and works with existing Medicare plans that retired seniors may already have.
How to Enroll in Medicare Part B
Who’s eligible for Medicare? Seniors turning 65 are automatically eligible for Medicare Part B benefits up to three months before their 65th birthday.
Follow the steps to determine your enrollment period and fill out the appropriate Medicare Part B form to get covered. You can also speak with a licensed agent with any questions about your Medicare coverage by calling (855) 634-0435.
Step #1 – Determine Your Enrollment Period
Medicare Part B eligibility depends on your birthday month — the first of the month, three months before your 65th birthday, is when the Initial Enrollment Period (IEP) for Medicare starts (Learn More: How to Sign Up for Medicare).
Medicare Part B Enrollment Periods| Enrollment Period | When It Occurs | What You Can Do |
|---|---|---|
| Initial Enrollment Period (IEP) | Begins 3 months before turns 65 & ends 3 months after turns 65 | Sign up for Parts A/B for the first time |
| General Enrollment Period (GEP) | Jan 1 – Mar 31 | Enroll if IEP was missed (with penalty) |
| Special Enrollment Period (SEP) | Within 8 months of job loss | Enroll in Parts A and/or B without penalty |
If you miss the IEP, you can sign up during the General Enrollment Period (GEP), but you will be charged a penalty for every year you were eligible but didn’t sign up for Medicare Part B.
Step #2 – Fill Out Medicare Part B Application
Visit the Social Security Administration (SSA) website to fill out the Medicare Part B application form. You’ll need to include your birth certificate, SSN, current health insurance coverage, and proof of legal residence (typically a utility or insurance bill).
Once online, you’ll have the option to sign up for Original Medicare or Medicare Part B only. If you have Medicaid coverage, you may be automatically or already enrolled in Part A. In that case, you’ll only need a valid email address and your current Medicare number to apply for Medicare Part B.
Step #3 – Receive Medicare Cards in the Mail
It typically takes 30 days to process Medicare Part B applications, and you’ll receive your Medicare card in the mail within a month. The card lists the start date of your coverage and should include a Medicare Part B provider phone number.
Read More: Best Gastroenterologists That Accept Medicare
Alternatives to Medicare Part B
What happens if I don’t want Medicare Part B? While there’s no true replacement for Medicare Part B, there are alternatives in how you get that kind of outpatient coverage.
- Medicare Advantage Plans: Also known as Medicare Part C, which includes all Part B benefits plus extras like vision, dental, or gym memberships, often bundled with drug coverage.
- Employer/Union Health Benefits: Some retirees keep employer or union retiree health benefits instead of or in addition to Part B.
- VA Health Benefits: Veterans can use VA health benefits, but VA coverage doesn’t replace Medicare and can limit provider choice.
If you skip Medicare Part B coverage, you’ll need another plan that covers doctor visits, tests, and outpatient treatments, or risk paying out-of-pocket for most outpatient care.
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What You Need to Know About Medicare Part B
Medicare Part B is the second half of Original Medicare that covers doctor visits, outpatient care, preventive services, durable medical equipment, and ambulances.
Medicare Part B Overview| Coverage | Details | Eligibility |
|---|---|---|
| Outpatient Care | Office visits, outpatient procedures, and same-day surgeries | Enrolled individuals age 65+ or with qualifying disability |
| Preventive Care | Flu shots, cancer screenings, annual wellness visits | Must be enrolled in Part B |
| Doctor Visits | Visits to primary care or specialists for diagnosis/treatment | Medicare-enrolled; medically necessary |
| Labs & Screenings | Blood tests, imaging (X-rays, MRIs), other screenings | Referred by Medicare-approved provider |
| Medical Equipment | Durable items like wheelchairs, walkers, oxygen equipment | Doctor’s prescription and Medicare approval |
| Ambulance | Emergency ground transport to hospital if medically necessary | Must meet Medicare transport criteria |
Why is Medicare Part B so expensive? Because it covers a wide variety of medical services, from outpatient care to medical equipment and ambulance rides, your Medicare Part B premium is higher than other Medicare plans that strictly cover hospital stays or prescription drugs.
Medicare Part B pays for the medical services and supplies you use to diagnose, treat, or prevent health problems outside of a hospital stay.
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The SSA offers Medicare Savings Programs (MSPs) that can help eligible seniors with limited income pay their Medicare bills, but many policyholders opt for Medicare Advantage plans that include additional benefits.
If you have any questions regarding your plan or payments, call the Medicare Part B phone number at (855) 634-0435 to speak with a licensed insurance agent.
Frequently Asked Questions
What is Medicare Part B for?
Medicare Part B covers the most common medical and preventative care services for seniors, including doctor appointments, medical equipment, and ambulance rides.
Is Medicare Part B free at age 65?
Unlike Medicare Part A, Part B insurance is not free. Does everyone pay $170 for Medicare Part B? All seniors pay the same monthly rate for Medicare Part B, but costs have increased by nearly 9% to $185 a month.
How much does Medicare Part B cost?
The average Medicare Part B premium is $185 per month.
How do I pay my Medicare Part B premium?
If you paid into Social Security, Medicare Part B premiums are automatically deducted from your benefits. Pay online or through the mail if you’re paying out-of-pocket. How much is taken out of Social Security for Medicare Part B? The average premium is $185 a month, but your rates could be adjusted based on income or employment.
Why do seniors pay for Medicare Part B?
Social Security benefits typically cover Medicare Part B premiums for seniors, unless you exceed certain income levels. Compare health insurance plans to find affordable coverage.
Who is exempt from paying Medicare Part B?
Do all retirees pay for Medicare Part B? Seniors with less than $10,000 in assets qualify for Medicare Savings Programs, which can cover some or all Medicare Part B costs. Others are also exempt from paying the Medicare Part B deductible and premium based on employment or health status.
What is the income limit for Medicare Part B?
Medicare Part B eligibility does not depend on income, but a higher income will raise your monthly rates. What income level triggers higher Medicare premiums? If you file more than $106,000 annually ($212,000 for married couples), your premiums will go up by 35% or more.
Does Medicare Part B cover prescriptions?
No, Medicare Part D pays for prescription drugs.
Does Medicare Part B cover dental?
No, Medicare Part B only covers routine and preventative medical costs.
Does Medicare Part B pay for surgery?
No, Medicare Part A covers surgery and other types of inpatient medical care.
Does Medicare Part B cover vision?
No, Medicare Part B covers outpatient medical costs only. Enter your ZIP code to find a Medicare plan near you with the coverage you need.
Are Medicare premiums tax-deductible?
Original Medicare premiums are only tax-deductible if you are self-employed or the cost of your premiums is 7.5% or more of your gross adjusted income. Use our insurance cheat sheet to create an itemized list of Medicare and other health insurance costs.
Why is Social Security no longer paying for Medicare Part B?
Social Security may no longer cover your Medicare Part B cost if you exceed certain income limits or have a Medicare Advantage Plan.
Enter your zip code below to view companies that have cheap insurance rates.
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Michelle Robbins
Licensed Insurance Agent
Michelle Robbins has been a licensed insurance agent for over 13 years. Her career began in the real estate industry, supporting local realtors with Title Insurance. After several years, Michelle shifted to real estate home warranty insurance, where she managed a territory of over 100 miles of real estate professionals. Later, Agent Robbins obtained more licensing and experience serving families a...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
