Medicare Part B, often referred to as “Medical Insurance,” is one of the two main parts of “Original Medicare” — the other being Part A (Hospital Insurance). While Part A mainly covers hospital stays and inpatient care, Part B is all about helping you stay healthy and receive essential medical services. Medicare Part B assists with two types of important medical costs: Medically necessary services and preventative services. These typically include services that would be classified under outpatient care. However, Part B also includes coverage for a few unexpected medical services.

Who Is Eligible for Medicare Part B Under Age 65?

Generally, Medicare Part B is available to people who are under 65 if they meet one of the following criteria:
  1. Disability: If you have been receiving Social Security disability benefits for at least 24 months, you will automatically become eligible for Medicare Part B.
  2. End-Stage Renal Disease (ESRD): Individuals with ESRD, such as kidney failure requiring dialysis or a kidney transplant, can also enroll in Medicare Part B, regardless of their age.

What Does Medicare Part B Cover?

Medicare Part B covers a wide range of medically necessary and preventive services, including:
  1. Doctor Visits: Part B helps pay for visits to doctors and other healthcare providers, including specialists.
  2. Preventive Services: Many preventive services are covered under Part B, such as flu shots, certain cancer screenings, and annual wellness visits.
  3. Outpatient Care: This includes services like lab tests, X-rays, durable medical equipment (like wheelchairs or crutches), and ambulance services.
  4. Mental Health Services: Part B covers both inpatient and outpatient mental health care services, including counseling and therapy.
  5. Medically Necessary Services: These can range from medically necessary surgeries and procedures to diagnostic tests.
  6. Certain prescription drugs: In general, prescription drugs are covered under Medicare Part D. However, Part B covers certain drugs that need to be injected or used with medical equipment.
  7. Emergency ambulance transportation: Medicare Part B ambulance coverage kicks in when other types of ground transportation would put your health in danger. Likewise, it may cover air transportation when necessary.
  8. Non-emergency ambulance transportation: You can get this coverage with a written order from your doctor explaining why ambulance transportation is necessary outside of an emergency.

How Much Does Medicare Part B Cost?

The cost of Medicare Part B can vary depending on your income. Most people pay the standard premium, while some may pay a higher premium based on their income. It’s important to keep in mind that there’s also an annual deductible you’ll need to meet before Medicare starts paying its share.
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Find Out How to Get Medically Necessary & Preventive Coverage With Medicare Part B
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Finally, Medicare Part B may also pay for certain necessary medical equipment, including but not limited to:
  • Blood sugar monitors and testing strips.
  • Crutches, canes, wheelchairs, walkers, etc.
  • Nebulizers and related medications.
  • Infusion pumps.
  • Oxygen equipment.
Depending on the type of equipment you need, Part B may help pay for you to buy it or rent it. Sometimes, however, you may need to pay for the equipment yourself.

Enrollment Periods

You have a seven-month Initial Enrollment Period to sign up for Medicare Part B, which typically starts three months before your 65th birthday, includes your birthday month, and extends for three months afterward. If you qualify for Part B due to disability, your Initial Enrollment Period will depend on when you became eligible. Note: The sooner you sign up for Medicare Part B, the lower your premiums will be. Applicants who wait to sign up after they have been eligible for some time will have to pay a higher amount each month. Medicare Part B plays a vital role in ensuring you have access to medically necessary and preventive healthcare services, regardless of your age. If you’re eligible, don’t miss your Initial Enrollment Period to enroll and start enjoying the benefits of this essential coverage.
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