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Medicare Part B – Medical Insurance

Original Medicare is made up of Part A – Hospital Insurance and Part B – Medical Insurance. You can think of Part B as coverage for everything outside of the Hospital except for Prescription Drugs (which are covered under Part D). We go into more detail about Part B in the video below:

What Does Medicare Part B Cover?

Covered services under Part B include:

  • Doctor visits (Primary Care and Specialist)
  • Emergency Room / Urgent Care
  • X-Rays and MRI’s
  • Preventive Services
  • Durable Medical Equipment (DME) like casts, crutches, diabetes test strips, and more.
  • Lab tests
  • Certain injectable medications that are received at the doctor/hospital

How Much Does Medicare Part B Cost Per Month?

Most Medicare beneficiaries will pay the minimum amount of $164.90 per month (2023). Historically, this number tends to rise by at least a couple percent each year. Those who earned above average income for tax year 2021, will see an Income Related Monthly Adjustment Amount (IRMAA) amount added onto their monthly Part B premium.

Individual Tax Return (2021) Joint Tax Return (2021) Monthly Part B Premium (2023) Monthly Part D IRMAA (2023)
$97k or less
$194k or less
+ $12.20
+ $31.50
+ $50.70
+ $70.00
+ $76.40

Medicare Part B Cost Sharing

For 2023, there is a once per year deductible of $226 before your Part B will begin its coverage.

Once the deductible is met, Medicare Part B will cover 80% of Part B charges that are medically necessary and from a provider who accepts Medicare.

There is no maximum out-of-pocket limit for Part B, which means you pay 20% no matter how high that percentage gets.

Coverage Stage Cost Sharing
$226 per calendar year

Medicare covers 80%

You owe 20%

Note: There is not a maximum out-of-pocket limit on the 20% Part B coinsurance.

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.

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