Medicare Part B (Medical Insurance) is part of Original Medicare and covers medical services and supplies that are medically necessary to treat your health condition and preventive services.
What’s Covered Under Part B
- Physician services (inpatient and outpatient)
- Durable medical equipment and supplies
- Home health care
- Mental health services
- Emergency Ambulance services
- Preventative services
- Therapy services
- Diagnostic and lab tests
- “Welcome to Medicare” physical exam
- Diabetic screening, services and testing supplies
- Glaucoma testing
- Shots and vaccinations (flu, pneumonia, hepatitis)
More services are covered than what is listed here. Refer to your Medicare & You handbook or go Medicare.gov for details about Medicare Part B benefits.
Medicare Part B Costs
Medicare Part B premiums may change from year to year, and the amount can vary depending on your situation. For many people, the premium is automatically deducted from their Social Security benefits.
Late Enrollment Penalty
If you didn’t get Part B when you were first eligible, you could pay a penalty. A surcharge of 10% for each year (12-month period) you could have had Part B but didn’t sign up will be added to your monthly premium.
Provider Limiting Charge
Medicare pays 80% of the Medicare-approved amount. If a provider accepts assignment s/he agrees to accept the Medicare approved amount for services provided. Providers who do not accept assignment may charge an additional 15% above the Medicare approved amount. This is called the Limiting Charge.
|Medicare Part B Costs|
|Part B Cost:||You Pay:|
|2023 Standard Part B premium (Based on 2020 tax income)||$164.90 per month|
|2023 Annual Deductible||$226|
|Copayment||20% of Medicare-approved charges & services|
|Late Enrollment Penalty||10% surcharge for each year not covered by Part B|
|Provider Limiting Charge||15% above Medicare-approved amount|
Income-Related Monthly Adjusted Amount (IRMAA)
Medicare’s Part B monthly premium is based on your tax income 2 years before you enroll. Many people pay the standard Part B premium based on an individual’s 2020 tax income of $97,000 or less. Couples’ 2019 tax income is $194,000 or less.
Higher premiums are charged for incomes above these levels. See the Part B Income-Related Monthly Adjusted Amount (IRMAA) chart below.
|Part B Income-Related Monthly Adjusted Amount (IRMAA)|
|Part B Income-Related Monthly Adjusted Amount (IRMAA) 2020 income tax filed in 2021||2023 Part B Premium|
|Individual Tax||Joint Tax|
|$97,000 or less||$194,000 or less||$164.90 **|
|$500,001 or more||$750,001 or more||$560.50|