What Does Medicare Part B Cover?
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Medicare Part B Insurance
Medicare Part B generally covers two main types of service. The first is medically necessary services and supplies that are needed to treat or diagnose your medical condition. These must also meet accepted standards of medical practice. The second type of service that Medicare Part B covers is preventive services to help discover issues early when treatment is most likely to work best. For example, some shots and vaccines are covered.
Part B Enrollment
You can enroll in Medicare Part B medical insurance during the Initial Enrollment Period, which begins three months before your 65th birthday and extends through the three months that follow your birth month. There is also a special enrollment period for those who are covered by a group health plan offered by a union or employer.
If you are already receiving benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Medicare Part B the first day of the month you turn 65. Anyone who is not receiving Social Security or RRB benefits when they turn 65 must enroll in Medicare through Social Security. If your birthday is on the first of the month, you will enroll in Medicare Part B on the first day of the previous month.
If you are disabled and under the age of 65, you will likely automatically get Medicare Part B once you receive Social Security disability benefits. Most people must pay a monthly premium, the cost of which may change depending on their income, to ensure Medicare Part B coverage. The premium is usually deducted from your monthly Social Security payments, depending on income.
If you were automatically enrolled in Medicare Part B and received a card in the mail, you can choose to opt out by sending the Medicare Part B card back: by keeping the card, you keep Medicare Part B and keep paying Medicare Part B premiums. If you signed up for Medicare through Social Security, contact Social Security.
If you chose not to enroll during your Initial Enrollment Period, you have the opportunity to sign up during the General Enrollment Period, which lasts between January 1 and March 31 each year. In many cases, if you don’t sign up for Medicare Part B when you’re first eligible, you have to pay a late enrollment penalty. For every one year period that you were qualified to enroll in but opted not to, your Medicare Part B monthly premium increases by 10 percent. You pay this penalty for the entire time you have Medicare Part B. If you meet certain conditions that allow you to sign up during the Special Enrollment Period, you may not have to pay this enrollment penalty.
Part B Outpatient Care
Medicare Part B provides patients with medically necessary outpatient health care. Physician services, nursing services, vaccinations, cardiovascular and diabetes screenings, lab services, and other preventive services are all covered by Medicare Part B. Medicare Part B will not pay for cosmetic surgery, custodial care, prescription drugs, dental or vision care, as well as some other services.
Medicare does not cover every health-related service or item. You may have co-payments and deductibles on services even if they are covered by Medicare. After you meet your deductible, your co-payments will generally cost around 20% of the Medicare-approved amount for most doctor services. If a service you need is not covered by Medicare, you must cover the costs yourself unless you have separate insurance that does.
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I’m a young lawyer and had no idea how Medicare worked. I was getting so many calls and was overwhelmed until a friend told me about Medicare Service. My experience was friendly, patient, and caring. They helped me pick a Medicare Advantage plan that didn’t cost me a dime. I never felt pressured—just supported!
Switching from my employer insurance to Medicare felt like jumping into the unknown. Thankfully, Medicare Service made it painless. They took the time to understand my situation and explained all my options clearly. They even checked that my heart specialist and medications were covered. I’ve already recommended them to my sister. Excellent service!
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Frequently Asked Questions
Do I have to pay for your services?
No, our help is 100% free. We’re paid by the insurance companies if you enroll in a plan, not by you. There’s no extra cost for working with us.
When can I enroll in Medicare?
Most people enroll around age 65 during their Initial Enrollment Period. There are also specific enrollment windows each year, such as the Annual Enrollment Period (October 15 – December 7), when you can make changes to your coverage.
What’s the difference between Medicare Part A, B, C, and D?
Medicare Part A: Hospital coverage (inpatient stays, skilled nursing, hospice, some home health).
Medicare Part B: Medical coverage (doctor visits, outpatient care, preventive services).
Medicare Part C: Medicare Advantage plans offered by private companies, combining Parts A & B and often including extra benefits like dental, vision, or prescriptions.
Medicare Part D: Prescription drug coverage.
Can I change my Medicare plan later?
Yes. You can make changes during the Annual Enrollment Period each year, and sometimes during Special Enrollment Periods if you qualify (for example, moving to a new area or losing other coverage).
Will I lose my doctor if I switch plans?
It depends on the plan you choose. Some Medicare Advantage and Part D plans have provider networks. Before switching, we’ll help you check whether your doctor is included in the plan’s network so you can keep your preferred providers.