What Is Medicare Part B?

Medicare has multiple parts. So what is Medicare Part B, and do you need it?

Sorting out your healthcare options after retirement can be confusing with so many different Medicare terms.

Medicare Part B is an optional plan for people who qualify for Medicare coverage. If you qualify for Medicare, you automatically get Part A, which provides hospital coverage.

Part B covers some of the medical care that Part A doesn't cover and comes with a monthly premium. The premium is based on your income. In 2022 that premium ranges from about $170 to $580 per month, according to Medicare.gov. You can make up to $91,000 on an individual tax return or $182,000 on a joint tax return to pay the lowest premium of $170.10.

What Does It Cover?

Part A, which mainly covers your medical bills for inpatient hospital stays, is typically referred to as hospital insurance.  Medicare Part B is designed to cover additional medical care, such as doctor visits, outpatient care and some preventative care. It's sometimes referred to as “medical insurance.”

Part B can also cover some items that your doctor decides are medically necessary. It's always a good idea to ask your doctor if a service or item is covered by Medicare before receiving medical care.

Part B has a deductible and co-insurance for expenses. In 2022, the deductible is $233 per year. After the deductible, Medicare typically covers 80% of the Medicare-approved amount for most covered services, with you paying the other 20%.

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Do You Need Medicare Part B?

While Part B is optional, most people need it to have complete coverage for common healthcare services. If either you or your spouse is still employed and has health insurance through an employer, you might not need Part B coverage immediately and can delay getting it. In some situations, delaying Part B could result in a penalty when you do enroll. If you don't have other coverage, Part B is important to make healthcare affordable. Without it, you could end up with significant medical debt. It's always best to get personalized advice to determine if and when you should get Part B coverage. Most states offer Medicare counseling services through a government agency.

Who Qualifies for Medicare Part B?

Most people qualify for Medicare Parts A and B when they turn 65. However, you can get Medicare coverage early if you're disabled or have end-stage renal disease.