Medicare Part B (medical insurance) is part of Original Medicare. Original Medicare is comprised of Medicare Part A and Medicare Part B. It’s a federal health insurance program designed to provide and reduce the cost of health care services in the United States. If you are eligible for Medicare Part A, then you can also enroll in Medicare Part B.
You are eligible for Original Medicare, including Medicare Part B, if you meet one of three criteria:
Medicare Part B covers preventative services and medically necessary services. This includes care to prevent an illness or detect it at an early stage – and services or supplies needed to diagnose or treat a medical condition.
Part B Medicare covers, but is not limited to:
There are many tests, items, and services that are not covered by Medicare Part B. These include routine dental, vision, and hearing care – such as check-ups, eyeglasses or contact lenses, hearing aids, dental extractions, and dentures.
We recommend that you ask your provider if your medical service or procedure will be covered by your Medicare plan. Learn more about whether a test, item, or service is covered.
The standard Part B premium amount in 2022 is $170.10. Most people pay the standard Part B premium amount.
If your Modified Adjusted Gross Income (MAGI) as reported on your IRS tax return from two years ago is higher than a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your standard premium.
Review the table below to see how much your monthly Part B premium will be – based on your income from two years ago.
|If your yearly income in 2020 (for what you pay in 2022) was||You pay each month (in 2022)|
|File individual tax return||File joint tax return||File married & separate tax returns|
|$91,000 or less||$182,000 or less||$91,000 or less||$170.10|
|above $91,000 up to $114,000||above $182,000 up to $228,000||N/A||$238.10|
|above $114,000 up to $142,000||above $228,000 up to $284,000||N/A||$340.20|
|above $142,000 up to $170,000||above $284,000 up to $340,000||N/A||$442.30|
|above $170,000 and less than $500,000||above $340,000 and less than $750,000||above $91,000 and less than $409,000||$544.30|
|$500,000 or above||$750,000 or above||$409,000 or above||$578.30|
Source: Part B Costs, Medicare.gov
The Part B premium will be automatically deducted from your benefit payment if you receive a Social Security, Railroad Retirement Board, or Office of Personnel Management benefit. If you don’t receive these benefits, you’ll receive a monthly or quarterly premium invoice.
There are some situations where you can appeal an IRMAA adjustment. These include having the IRMAA based on a tax amount that is inaccurate or out-of-date, or one of seven life-changing events.
Seven life-changing events:
When any of these occur, you can request an appeal in writing by completing a request for reconsideration form with the Social Security Administration. You can also call the Social Security Administration at 1-800-772-1213.
Looking for ways to reduce your Medicare Part B premium? If you are lower-income and meet specific criteria you may qualify for a Medicare Savings Program. There are three programs (Qualified Medicare Beneficiary Program, Specified Low-Income Beneficiary Program, and Qualifying Individual Program) that could help you pay for all or most of your Medicare Part B premium.
Also, some Medicare Advantage plans can reduce the cost of the Part B premium through a give-back benefit.
To see if you qualify for a Medicare Savings Program or a give-back benefit, speak to a local licensed Connie Health agent who can help you navigate your Medicare journey. Call (623) 223-8884 (TTY: 711).
Your Medicare Part B costs also include an annual deductible. In 2022, the Part B deductible is $233.
After your deductible is met ($233 in 2022), you pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.
Original Medicare does not have a maximum on these out-of-pocket expenses. This is why most Medicare enrollees have either Medicare Supplemental insurance plus their Medicare prescription drug coverage (Medicare Part D plan). Or they choose to enroll in a Medicare Advantage Prescription Drug Plan, which covers all these needs.
You are first eligible for Medicare during your Initial Enrollment Period. For most, the Initial Enrollment Period begins three months before your 65th birthday, the month you turn 65, and ends three months after your 65th birthday. You have this seven-month window to enroll in Medicare.
Should you miss your Initial Enrollment Period, you can enroll in Medicare Part B during the General Enrollment Period (January 1 – March 31), or a Special Enrollment Period, if you qualify.
You can turn down or delay Medicare Part B enrollment. If you decide to enroll later on, your coverage could be delayed. And if you don’t have creditable coverage during that time, you may pay a late enrollment penalty.
“If you decline Part B and don’t have creditable coverage, you could pay a late enrollment penalty that lasts as long as you have Medicare Part B.“
This penalty will be added to your Part B premium as long as you have Medicare Part B. The penalty could cause your premium to increase up to 10 percent for each year you were eligible for Part B and chose not to sign up – unless you qualify for a Special Enrollment Period.
Want to be sure that it’s the right time to enroll in Medicare Part B? Speak to a local licensed Medicare agent who can help you make the best decision for your health and finances. Call (623) 223-8884.
Suppose you are not retired and receive benefits from the Social Security Administration or Railroad Retirement Board at least four months before turning 65. You’ll need to sign up with the Social Security Administration to get Medicare Part A.
If you have private health insurance through your or your spouse’s employer, you can choose to delay Medicare Part B until you retire and receive Social Security benefits.
You can enroll in Parts A & B if you’re eligible for Medicare because of End-Stage Renal Disease. You can choose whether or not to sign up for Part B. However, you’ll need Parts A & B to cover certain services under Medicare, including dialysis and kidney transplant services.
Read more about End-Stage Renal Disease and Medicare to make an informed decision.
Here are the four ways to apply for Original Medicare (Medicare Parts A & B) through the Social Security Administration. Already enrolled in Medicare Part A? Skip to the next section.
Choose the most convenient method for you:
Already enrolled in Medicare Part A , but previously declined Medicare Part B? You can enroll during your Initial Enrollment Period, General Enrollment Period, or a Special Enrollment Period. The timing depends on why you initially declined to enroll in Medicare Part B.
Read How to Apply for Medicare Part B if you previously declined Medicare Part B during your Initial Enrollment Period.
Last updated: May 6, 2022
Read more by David Luna
I am a Spanish-speaking Arizona Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2005. I am a Marine Corps Veteran & former police officer. I enjoy watching football and basketball but hold family time in the highest regard.