Medicare Part B
Get Local Medigap QuotesCommonly referred to as the "Doctor" part
Most people refer to Medicare Part B as the doctor portion of Medicare but it actually covers much more. Part B is also what people are referring to when they say Medicare covers 80%, this is the most simplified way to think of Part B
How Much is Medicare Part B?
The standard monthly premium for Medicare Part B is $164.90. Cost can go up depending on your income. This adjustment is known as the Income Related Monthly Adjustment Amount. IRMAA only affects about 7% of the people on Medicare.
Income Related Monthly Adjustment Amount
The Income Related Monthly Adjustment Amount is based on your income from two years prior.
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Full Part B Coverage |
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Beneficiaries who file individual tax returns with modified adjusted gross income: |
Beneficiaries who file joint tax returns with modified adjusted gross income: |
Income-Related Monthly Adjustment Amount |
Total Monthly Premium Amount |
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Less than or equal to $97,000 |
Less than or equal to $194,000 |
$0.00 |
$164.90 |
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Greater than $97,000 and less than or equal to $123,000 |
Greater than $194,000 and less than or equal to $246,000 |
$65.90 |
$230.80 |
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Greater than $123,000 and less than or equal to $153,000 |
Greater than $246,000 and less than or equal to $306,000 |
$164.80 |
$329.70 |
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Greater than $153,000 and less than or equal to $183,000 |
Greater than $306,000 and less than or equal to $366,000 |
$263.70 |
$428.60 |
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Greater than $183,000 and less than $500,000 |
Greater than $366,000 and less than $750,000 |
$362.60 |
$527.50 |
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Greater than or equal to $500,000 |
Greater than or equal to $750,000 |
$395.60 |
$560.50 |
Annual Deductible $226
Each year you are responsible for the first $226 of Part B Medicare-approved expenses.
Approved Expenses 20%
You are responsible for 20% of all Medicare approved expenses, some of these expenses include doctors’ services for both inpatient and outpatient medical and surgical services, physical and speech therapy, durable medical equipment, diagnostic test and blood after the first 3 pints.
Excess Charges 100%
Doctors’ have the option to charge over and above the Medicare approved amount these charges are referred to as excess charges, you are responsible for 100% of all excess charges.
Important Take Away
There is no cap to the amount of money Medicare is willing to spend on your approved medical bills, this is a good thing but this also means there is no cap to the 20% and Excess Charges that you may have in your life.
Who’s Eligible for Part B?
Part B is voluntary, there are different eligibility requirements. If you qualify for premium-free Part A, then you also qualify for Part B.
If you have to pay for Part A, you must be at least 65 years of age, a resident of the country, and either a legal citizen or a lawfully admitted, permanent resident alien with at least five continuous years of residency before applying for Medicare Part B.
What Does Part B Cover?
Part B covers two important things:
- Medically necessary services
- Preventative Services
Medically necessary services are any services you need for the diagnosis or treatment of a medical condition.
Preventive Services are yearly wellness check-ups, flu shots, or standard medical tests designated to detect diseases early, helping reduce the cost of treatment and the likelihood of bad outcomes in the future.
Additional Part B Services
- Durable medical equipment
- Clinical research
- Certain outpatient prescription drugs
- Ambulance services
- Mental health services, including inpatient, outpatient, and partial hospitalization services
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800 MEDICARE to get information on all of your options.
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Last updated: 01.05.2023 at 12:01 AM MULTIPLAN_SHDLEAWE001_M.