How do I get Medicare Part B and how much does it cost?

Medicare Part B covers outpatient medical services like doctor visits, preventive care, durable medical equipment, and more. Enrollment If you're already receiving Social Security benefits when you turn 65, you'll typically be enrolled in Part B automatically. If not, you'll need to sign up during your Initial Enrollment Period , which begins three months before the month you turn 65 and ends three months after. If you delay enrollment without qualifying for a Special Enrollment Period (such as having employer-sponsored coverage), you may face a late enrollment penalty . This penalty adds 10% to your monthly premium for each full 12-month period you were eligible but didn't enroll, and you'll pay this higher premium for as long as you have Part B. Costs in 2025 Standard Monthly Premium : $185 Annual Deductible : $257 After meeting the deductible, you typically pay 20% of the Medicare-approved amount for most services. Income-Related Monthly Adjustment Amount (IRMAA) If your Modified Adjusted Gross Income (MAGI) from two years ago (2023 for 2025 premiums) is above certain thresholds, you'll pay an additional amount on top of the standard premium: Individual MAGI Joint MAGI Total Monthly Premium (2025) $106,000 or less $212,000 or less $185.00 $106,001 – $133,000 $212,001 – $266,000 $259.00 $133,001 – $167,000 $266,001 – $334,000 $370.00 $167,001 – $200,000 $334,001 – $400,000 $480.90 $200,001 – $500,000 $400,001 – $750,000 $591.90 $500,001 or more $750,001 or more $628.90 Note: If you're married and file separately, different thresholds apply. If you believe your IRMAA is incorrect due to a life-changing event (like retirement or loss of income), you can request a reconsideration from the Social Security Administration.

What does Medicare Part B cover?

Medicare Part B is known as your medical coverage . It helps pay for outpatient and physician services, as well as many preventive services that can catch health issues early or help you avoid them altogether. Part B covers two main types of care: Medically necessary services – Services or supplies needed to diagnose or treat a condition, based on accepted standards of medical practice. Preventive services – Routine care like screenings and vaccines to prevent illness or detect problems early. You usually pay nothing for these services if your provider accepts Medicare assignment. Examples of what Part B covers include: Doctor visits – Includes outpatient visits and doctors who treat you in the hospital (even though the hospital stay itself is Part A). Outpatient surgery – Medical procedures that don’t require an overnight hospital stay. Clinical research – Participation in qualifying clinical trials. Ambulance services – Emergency transportation when other options would put your health at risk. Durable medical equipment (DME) – Items like wheelchairs, walkers, oxygen, or CPAP machines, when prescribed for use at home. Mental health care – Includes outpatient therapy, inpatient psychiatric care, and partial hospitalization programs. Second opinions before surgery – Medicare may cover a second (and sometimes third) opinion before certain procedures. Limited outpatient prescription drugs – Such as some cancer drugs, injectables, or medications given in a clinical setting.

How do I get Medicare Part A and how much does it cost?

Medicare Part A, often referred to as "hospital insurance," is typically premium-free for individuals who have worked and paid Medicare taxes for at least 40 quarters (equivalent to 10 years), or who are married to someone who has. During your working years, you and your employer each contribute 1.45% of your wages to fund Medicare Part A. If you have fewer than 40 quarters of Medicare-covered employment, you can still enroll in Part A by paying a monthly premium. In 2025, the premium rates are as follows: $285 per month for individuals with 30–39 quarters of coverage. $518 per month for those with fewer than 30 quarters of coverage. Generally, if you're already receiving Social Security benefits when you turn 65, you'll be automatically enrolled in Part A. If not, you can sign up through the Social Security Administration during your Initial Enrollment Period, which begins three months before the month you turn 65 and ends three months after. Additionally, individuals under 65 may qualify for Medicare Part A if they have received Social Security Disability Insurance (SSDI) for at least 24 months or have been diagnosed with End-Stage Renal Disease (ESRD).

What does Medicare Part A cover?

Medicare Part A is often called your hospital coverage . It primarily helps pay for inpatient care and other medically necessary services provided in a facility setting. While Part A covers hospital facility charges , keep in mind that doctors who treat you in the hospital usually bill separately under Medicare Part B . Here’s what’s generally covered under Part A: Inpatient hospital care – Includes your room, meals, general nursing, and other hospital services and supplies during an admitted stay. Skilled nursing facility (SNF) care – Covers short-term rehab after a hospital stay if you need skilled nursing or therapy services. Nursing home care – Only covered when skilled nursing care is medically necessary. Custodial care (help with activities of daily living like bathing or eating) is not covered, even if provided in a nursing home. Hospice care – If you’re terminally ill and forgo curative treatment, Part A covers hospice services focused on comfort and quality of life. Home health services – May be covered for a limited time if you need skilled care and are homebound. 💡 Important: Medicare does not pay for long-term custodial care, whether in a facility or at home. This includes help with day-to-day tasks unless skilled care is also needed.

Medicare is a federal health insurance program primarily for people age 65 and older. It also covers certain individuals under 65 who have received Social Security disability benefits for at least two years, and people of any age diagnosed with End-Stage Renal Disease (ESRD). The program was signed into law in 1965 and has evolved over time. Major milestones include the creation of Medicare Advantage plans through the Balanced Budget Act of 1997 and the addition of prescription drug coverage (Part D) via the Medicare Modernization Act of 2003. “ Original Medicare ” includes two parts: Part A , which covers hospital-related expenses, and Part B , which covers outpatient medical services like doctor visits and preventive care. While these two parts form the foundation of Medicare, they don’t cover everything—there are deductibles, coinsurance, and no cap on out-of-pocket spending. That’s why most people choose to add coverage through either a Medicare Supplement (Medigap) policy or a Medicare Advantage plan , depending on their needs and preferences.

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How do I get Medicare Part B and how much does it cost?
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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.

JME INSURANCE AGENCY IS NOT CONNECTED WITH OR ENDORSED BY THE UNITED STATES GOVERNMENT OR THE FEDERAL MEDICARE PROGRAM.