- Medicare Part B covers medical costs like doctor’s visits, blood tests, imaging scans and more.
- If you don’t sign up on time for Part B, you may have to pay a lifetime late enrollment penalty.
- You pay a set monthly premium for Medicare Part B, which is $170.10 a month in 2022 for most people but varies according to income.
- Medigap and Medicare Advantage plans are options that can help with costs, but they have their disadvantages.
Is there anything more complicated than Medicare? Probably, but we’re guessing not by much. You may know that Medicare Part A, which covers hospital visits, is free once you enroll. But Medicare Part B, which covers non-emergency care, like regular check-ups and tests, is not.
Just how much will Part B cost you, and what are the variables that can affect your costs?
We’ll break Medicare Part B down so you know exactly what it covers and how hard it may hit your wallet. And we’ll tell you how and when to sign up so you can avoid a costly late enrollment penalty.
Inside this article
What is Medicare Part B?
Need to go to the doctor for an ache, an injury or the flu? That’ll be covered by Medicare Part B, the medical insurance part of Medicare. As you probably know, Medicare is the federal health insurance program for people 65 and older and some with disabilities.
There are three main parts of Medicare:
Medicare Part A: Hospital coverage
Medicare Part B: Medical coverage
Medicare Part D: Prescription drug coverage
“Medicare Part B covers outpatient medical bills,” says David Belk, M.D., health care advocate and founder of True Cost of Health Care. “This includes bills from doctor’s office visits, doctors who see you in hospital emergency rooms, blood tests, X-rays, CT scans, MRIs, chemotherapy infusions, outpatient surgeries, overnight ‘observation’ stays in a hospital and much more.”
However, keep in mind: “Part B does not cover most prescription drugs, eyeglasses, hearing aids or dental care,” Belk says.
How much is Medicare Part B?
You pay a set monthly premium for Medicare Part B, which is $170.10 a month in 2022 for most people.
The cost of your Medicare Part B premiums is based on your modified adjusted gross income from your IRS tax return from two years ago. So in 2022, your Part B premium amount is based on your federal tax return from 2020.
You’ll pay the standard amount if you earned $91,000 a year or less ($182,000 or less if you filed a joint tax return) two years ago.
“The cost of those premiums increases for those who earned more,” Belk says.
Here’s a look at how premiums can differ:
|Income on individual tax return in 2020||Income on joint tax return in 2020||Medicare Part B premium cost in 2022|
|Up to $91,000||Up to $182,000||$170.10|
|Over $91,000 to $114,000||Over $182,000 to $228,000||$238.10|
|Over $114,000 to $142,000||Over $228,000 to $284,000||$340.20|
|Over $142,000 to $170,000||Over $284,000 to $340,000||$442.30|
|Over $170,000 to under $500,000||Over $340,000 to under $750,000||$544.30|
|$500,000 and over||$750,000 and over||$578.30|
Cost of Medicare Part B copays and deductibles
Premiums aren’t your only out-of-pocket cost for Medicare Part B. You also have to pay a deductible and copays. This makes it a little harder to know exactly how much it’ll cost you each month or year.
The Medicare Part B deductible is $233 a year
The Medicare Part B copay is 20% of the Medicare-approved amount.
Once you’ve met the Part B deductible in a given year, you’ll then start paying only the copay of 20% of the cost of the Medicare-approved amount for doctor’s visits and other outpatient care. However, most blood tests and preventive services are free with Medicare, Belk says.
It’s important to know that Medicare usually only approves an average of about 15% to 20% of any medical bill, meaning you’ll only be responsible for 20% of the 15% to 20% Medicare-approved amount, Belk points out.
“If you get an MRI and Medicare approves $600 for that MRI, you owe 20% of $600 or $120. That’s it,” Belk says. “It doesn’t matter if the bill for that MRI was $4,000. You’re only responsible for 20% of Medicare’s approved rate, not the billing charge.”
Can Medigap and Medicare Advantage help you save?
It’s true you can get a Medigap plan to help pay some of your Part B out-of-pocket costs. But Medigap plans for new Medicare patients do not pay the Medicare Part B deductible. And the plans can get quite expensive.
Belk points out that a Medigap plan that starts out with, say, a $130 per month premium when you’re 65 could balloon to $200 a month when you’re 70, and so on.
Another option could be getting a Medicare Advantage plan, which is sold by private insurers and encompasses what you’d get in Medicare Parts A and B, plus some extras. Medicare Advantage, also known as Medicare Part C, is a different way of getting your benefits.
These plans have different structures and costs, but have to follow Medicare rules and may cover some items Medicare doesn’t cover—for example, an eye exam, hearing aids or a trip to the dentist to get a filling.
But while it may sound like Advantage plans simplify things, Belk says they’re anything but simple, and they might not save you money. “These plans are deliberately confusing and, in every case, you’re inviting a middleman to manage your benefits for you,” Belk says. “That can only ever cost more in the long run.”
How to get Medicare Part B
Ready to enroll in Medicare? You can sign up for Part B during your initial enrollment period when you turn 65, says Gayle Byck, Board Certified Patient Advocate (BCPA) and Certified Senior Advisor (CSA) with InTune Health Advocates.
If you have health insurance through your or your spouse’s job and don’t need Part B, you will get an eight-month Special Enrollment Period to enroll in Part B when that coverage ends. If you miss those enrollment periods, you can still enroll in Part B during the yearly General Enrollment Period from January through March, but that coverage would not begin until July 1, and it would cost you more, says Byck.
You can sign up for both Part A and Part B by applying online at the Social Security website. If you already have Part A and just want to get part B, you can fill out a Medicare Part B enrollment form, and fax or mail it to your local Social Security office. Or, you can call 800-772-1213 or contact your local Social Security office.
It may not be possible to know exactly how much Medicare Part B will cost you since the amount you pay for copays varies based on the medical care you need. But signing up on time, and skipping the supplemental insurance, may help keep money in your pocket.