Are you wondering how Medicare Part B works in Virginia and whether it’s the right time for you to enroll? Look no further—here’s your comprehensive, easy-to-follow guide to understanding Medicare Part B coverage and costs and how it can benefit your healthcare needs.
91.44% of eligible Medicare beneficiaries in Virginia are enrolled in Medicare Part B.
If you qualify for a Medicare Savings Program in Virginia, you could pay $0 for your Medicare Part B premium.
The 2025 Medicare Part B minimum premium is $185.00.
In 2025, you could pay up to $628.90 per month for your Medicare Part B premium.
The 2025 Medicare Part B deductible is $257.00.
There is no cap on Medicare Part B out-of-pocket costs, which could risk your health and finances. But there are supplemental insurance options that could help.
Medicare Part B, also known as medical insurance, is one component of Original Medicare. Original Medicare consists of two parts: Medicare Part A and Medicare Part B. This federal health insurance program is designed to make healthcare services more affordable across the United States. If you’re eligible for Medicare Part A, you can also enroll in Medicare Part B.
You meet the eligibility requirements for Original Medicare, including Medicare Part B, if you satisfy at least one of the following conditions:
You are 65 or older.
You are under 65 but have qualifying disabilities as determined by the Social Security Administration.
You have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
Medicare Part B primarily provides coverage for medically necessary and preventive care services. Some of the key items included are:
Visits to doctors and specialists (e.g., cardiology, orthopedic, and radiology services).
Preventive care, including annual wellness visits and cancer screenings like mammograms or colonoscopies.
Mental health services, including inpatient, outpatient, and partial hospitalization treatments.
Vaccinations include flu shots, pneumococcal vaccines, and Hepatitis B vaccinations.
Ambulance rides and necessary Durable Medical Equipment (e.g., wheelchairs, CPAP machines).
Limited outpatient prescription drugs.
On the other hand, routine services like dental, vision, and hearing care aren’t covered under Part B. If dental, vision, or hearing are essential, you may want to consider a Medicare Advantage plan or other supplemental insurance options.
Quick Tip: Always confirm with your healthcare provider to ensure your necessary procedures or services are covered by Medicare Part B. If you have a procedure done and it’s not covered by Medicare Part B, you could be liable for the entire cost.
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When enrolling in Medicare Part B, you should be prepared for a few costs, including the monthly premium, deductible, and coinsurance or copays.
For 2025, the standard Medicare Part B premium is $185.00. Higher-income individuals may pay an additional amount known as the Income-Related Monthly Adjustment Amount (IRMAA). The IRMAA is an extra amount you must pay in addition to the standard monthly Medicare Part B premium.
If you are subject to an Income-Related Monthly Adjustment Amount, the most you would pay for your Medicare Part B premium is $628.90 per month. The amount is based on your Modified Adjusted Gross Income (MAGI) from two years prior. Review the Income-Related Monthly Adjustment Amount in the table below to determine if you will pay an Income-Related Monthly Adjustment Amount and how much your total Medicare Part B monthly premium may be.
| If the yearly modified adjusted gross amount in 2023 (for what you pay in 2025) was: | ||||
|---|---|---|---|---|
| File individual tax return | File joint tax return | File married & separate tax return | Income Related Monthly Adjustment Amount | Total Medicare Part B Premium Amount |
| $106,000 or less | $212,000 or less | $106,000 or less | $0 | $185.00 |
| Above $106,000 up to $133,000 | Above $212,000 up to $266,000 | Not applicable | $74.00 | $259.00 |
| Above $133,000 up to $167,000 | Above $266,000 up to $334,000 | Not applicable | $185.00 | $370.00 |
| Above $167,000 up to $200,000 | Above $334,000 up to $400,000 | Not applicable | $295.90 | $480.90 |
| Above $200,000 and less than $500,000 | Above $400,000 and less than $750,000 | Above $106,000 and less than $394,000 | $406.90 | $591.90 |
| $500,000 or above | $750,000 or above | $394,000 or above | $443.90 | $628.90 |
If you have a life-changing event such as a marriage, divorce, the death of a spouse, loss of income, or an employer settlement payment, you may ask to lower the additional amount you pay for Medicare Part B. You must contact your local Social Security office and request to reduce the Income-Related Monthly Adjustment Amount.
The annual Medicare Part B deductible for 2025 is $257.00. Once you meet this amount, Medicare begins to share your healthcare costs.
After your deductible, Medicare Part B covers 80% of Medicare-approved expenses while you pay the remaining 20% as coinsurance. However, there’s no cap on out-of-pocket costs. So, supplemental coverage like Medicare Supplement (Medigap) or Medicare Advantage (Medicare Part C) could be beneficial in protecting yourself from high out-of-pocket costs
Learn more about Medicare Supplement and Medicare Advantage plan options in Virginia.
Three programs pay for the Medicare Part B premium, and one could cover most of your Medicare Part B out-of-pocket expenses, such as the Part B deductible, coinsurance, and copays. So, if you qualify, you could get Medicare Part B for free - and more.
In most states, there are 3 Medicare Savings Programs that, if you qualify, will cover the cost of your Medicare Part B premium. These include the Qualified Medicare Beneficiary (QMB) Program, the Specified Low-Income Medicare Beneficiary (SLMB) Program, and the Qualifying Individual (QI) Program. Individual states manage these programs and could vary.
You may need to meet certain monthly income and financial resource requirements to qualify for one of these programs. Review the three tables below to determine if you are eligible for free Part B. And contact your Minnesota office to confirm eligibility and for help enrolling. Call 1-800-333-2433 or visit the Minnesota Medicare Savings Programs website.
| Marital Status | Monthly Gross Income Eligibility | Financial Resources Eligibility |
|---|---|---|
| Single | $1,325 | $9,660 |
| Married | $1,783 | $14,470 |
| Marital Status | Monthly Gross Income Eligibility | Financial Resources Eligibility |
|---|---|---|
| Single | $1,585 | $9,660 |
| Married | $2,135 | $14,470 |
| Marital Status | Monthly Gross Income Eligibility | Financial Resources Eligibility |
|---|---|---|
| Single | $1,781 | $9,660 |
| Married | $2,400 | $14,470 |
If you qualify for a Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), or Qualifying Individual (QI) Medicare Savings Program, these are the Medicare Part B benefits and more you could expect to receive.
| Medicare Savings Program | Part A Hospital Deductible | Part A Hospital Copays | Part A Skilled Nursing Facility Copays | Part A Monthly Premium | Part B Annual Deductible | Part B Monthly Premium | Part B 20% Coinsurance |
|---|---|---|---|---|---|---|---|
| Qualified Medicare Beneficiary (QMB) | $1,676 per benefit period | Days 61-90 ($419 daily), Days 91-150 ($838 daily) | $209.50 daily | Up to $518 monthly | $257 annually | $185 monthly | Varies on Medicare approved amounts |
| Specified Low-Income Medicare Beneficiary (SLMB) | No benefit | No benefit | No benefit | No benefit | No benefit | $185 monthly | No benefit |
| Qualifying Individual (QI) | No benefit | No benefit | No benefit | No benefit | No benefit | $185 monthly | No benefit |
Medicare Part B doesn’t cover everything, so many enrollees sign up for additional coverage to reduce out-of-pocket expenses. You may consider the following plans:
Medicare Advantage (Part C): Combines Part A, Part B, and often Part D (prescription coverage), along with additional benefits like dental, vision, hearing, and more.
Medigap Plans (Medicare Supplement) cover out-of-pocket costs not fully covered by Original Medicare, such as copayments, coinsurance, and deductibles.
See how a Medicare Advantage plan in Virginia could provide you additional coverage at a lower cost or how a Medicare Supplement plan in Virginia could protect you from high out-of-pocket costs. If you’d like personalized assistance weighing your plan options, call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent today.
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When it comes to Medicare Part B, enrollment timing is everything. Based on your eligibility and circumstances, you have several opportunities to enroll. Read below to learn how to avoid Medicare Part B late enrollment penalties.
Your Initial Enrollment Period is a 7-month window that begins three months before your 65th birthday, includes the month you turn 65, and ends three months after your birthday. This is the best time to enroll and avoid late enrollment penalties.
If you miss your Initial Enrollment Period, you can enroll between January 1 and March 31 each year during the General Enrollment Period. Coverage will begin the first day of the month after you enroll, and you may face a late enrollment penalty.
You might qualify for a Special Enrollment Period if you delayed enrollment because you had creditable coverage through an employer or other qualifying group plan. This allows you to enroll without penalties for up to 8 months after your existing coverage ends.
You will typically be automatically enrolled in Medicare Part A and Part B if you receive Social Security or Railroad Retirement benefits before you turn 65.
Choosing to delay Medicare Part B enrollment might seem like a smart move if you have employer coverage. However, it’s essential to evaluate your situation carefully. Without creditable coverage, you may face a late enrollment penalty that increases your monthly premium by 10% each year you delay enrollment.
Helpful Advice: If you’re unsure about delaying enrollment, call 1-888-976-57821-888-976-5782 to speak with an agent who can review your current coverage and future healthcare needs.
Signing up for Medicare Part B is easy and can be done in multiple ways through the Social Security Administration. Here are your options:
Apply online at Social Security Medicare Benefits.
Visit or call your local Social Security office.
Call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent who can help you get your Medicare journey off to the best start and weigh your Medicare plan options.
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How to apply for Medicare Part B in Virginia?
Here’s how to apply for Medicare Part B:
Apply online at Social Security Medicare Benefits.
Visit or call your local Social Security office.
Call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent who can help you get your Medicare journey off to the best start and weigh your Medicare plan options.
It’s important to note that Medicare Part B does not include a maximum out-of-pocket limit. Once enrolled in Part B, consider options like a Medicare Advantage plan or a Medicare Supplement (Medigap) policy to safeguard yourself from significant out-of-pocket expenses and potential medical bills.
Need tailored guidance? Contact a local licensed Connie Health agent today at 1-888-976-57821-888-976-5782 to ensure your Medicare coverage fits your healthcare and financial needs.
How much does Medicare Part B cost in Virginia?
Medicare expenses depend on your income and include the monthly Part B premium, an annual deductible, coinsurance, and copayments.
The standard Medicare Part B premium for 2025 is $185.00. Most individuals will pay this base premium amount. However, if your Modified Adjusted Gross Income (MAGI) from two years ago exceeds a set threshold, you'll need to pay an additional charge called the Income-Related Monthly Adjustment Amount (IRMAA). For 2025, this could mean monthly Part B premiums as high as $628.90.
Medicare Part B also has an annual deductible, which is $257.00 in 2025. You'll need to cover this deductible before Medicare begins sharing costs.
After meeting the annual deductible, Medicare will cover 80% of approved expenses, while you are responsible for the remaining 20% as coinsurance. It’s important to note that there’s no limit on this 20% coinsurance, which is why many Medicare beneficiaries supplement their coverage with a Medicare Supplement plan or Medicare Advantage plan to help minimize their out-of-pocket expenses.
If you’d like to speak with someone about Medicare Part B's costs and learn whether the Income-Related Monthly Adjustment Amount will impact you, call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent.
What is Part B Medicare?
Medicare is a federal health insurance program that helps reduce healthcare costs in the United States. It is available to individuals aged 65 and older, younger individuals with qualifying disabilities, and those with End-Stage Renal Disease.
The program is divided into multiple parts, with Medicare Part A covering hospital-related expenses and Medicare Part B focusing on medical services. If you qualify for Medicare Part A, you also have the option to enroll in Medicare Part B.
Medicare Part B is voluntary and offers coverage for two categories of services:
Medically necessary services include treatments or supplies required to diagnose or manage a medical condition, following established medical practice guidelines
Preventive services: These services aim to prevent illnesses or identify them early, when treatment is likely to be most effective.
While enrollment in Medicare Part B is optional, it plays a key role in many people’s healthcare plans, offering additional protection from medical expenses.
Not sure if Medicare Part B is right for you or if now is the best time to enroll? A local licensed Connie Health agent is ready to assist. Call 1-888-976-57821-888-976-5782 for guidance on choosing the Medicare coverage that suits your health and financial needs.
Does Medicare Part B cover prescriptions?
Medicare Part B provides limited prescription coverage. It typically covers medications administered in a clinical setting, such as injectable drugs or those used during outpatient procedures. However, most prescription drugs taken at home are not covered under Part B. For broader prescription coverage, you may need to enroll in a Medicare Part D or Medicare Advantage plan with drug benefits.
Wondering whether a Medicare Part D or Medicare Advantage plan would cover your prescription drug needs best? Call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent who can answer your questions and help you find the ideal coverage.
What is IRMAA Medicare?
IRMAA, or Income-Related Monthly Adjustment Amount, is an additional charge that high-income Medicare beneficiaries may need to pay for their Medicare Part B (medical insurance) and Part D (prescription drug coverage) premiums. This surcharge is calculated based on your modified adjusted gross income (MAGI) two years prior. If your income exceeds specific thresholds set by the IRS, you'll be subject to IRMAA.
If you’d like to speak with someone about Medicare Part B's costs and learn whether the Income-Realted Monthly Adjustment Amount will impact you, call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent.
Where are Medicare Part B giveback areas located?
Medicare Part B giveback areas can be found in locations across the United States, but availability varies depending on your zip code and chosen Medicare Advantage plan. The Part B giveback benefit, also known as the Part B premium reduction, is offered by certain Medicare Advantage plans to lower your monthly Part B premium.
To find a Medicare Advantage plan that offers a Part B giveback benefit in Virginia, Minnesota, call 1-888-976-57821-888-976-5782 and speak with a local licensed Connie Health agent. An agent can help guide you to a plan with the correct cost and coverage.
Where can I get more information about Medicare Part B in Virginia, Minnesota?
For more information about Medicare Part B in Virginia, Minnesota, call 1-888-976-57821-888-976-5782 and speak with a local licensed agent in your area. You can make an appointment to speak in person, over the phone, or via video chat.
Medicare Part B is available in the following zip codes in Virginia, Minnesota: 55777, 55792
“2025 Medicare Parts A & B Premiums and Deductibles,” CMS.gov.
“Cost of Medicare Part B Premium, Deductible & More,” Connie Health.
“Medicare Income-Related Monthly Adjustment Amount - Life Changing Event,” SSA.gov.
“Medicare Monthly Enrollment,” Data.CMS.gov.
“Medicare Part B: What Does it Cover & When to Enroll?” Connie Health.
“Medicare Savings Programs,” Medicare.gov.
“Request to lower an Income-Related Monthly Adjustment Amount (IRMAA),” SSA.gov.
“Where Can People Get Help With Medicaid & CHIP?” Medicaid.gov.
Last updated: April 17, 2025
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