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Original Medicare is made up of two parts: Medicare Part A provides hospital insurance, while Medicare Part B offers medical insurance. Together, these two parts equal Original Medicare, the federally administered health-care program for seniors and certain disabled individuals.
Medicare Part B covers medically necessary services and supplies, including doctor visits, preventive care, and durable medical equipment.
The following are some examples of what Medicare Part B covers:
If you’re enrolled in a Medicare Advantage plan, you’ll still be covered for the same Medicare Part A and Part B coverage you would have had under Original Medicare. Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare, so you’ll have the same baseline level of benefits that you would have under the federal program. In addition, your Medicare Advantage plan may cover other benefits to keep you healthy, such as routine vision or dental, wellness programs, or prescriptions drugs.
To be eligible for Medicare, you must be a United States citizen or legal permanent resident of at least five continuous years and 65 years or older. You can also be eligible for Medicare before 65 if you’ve been receiving disability benefits from Social Security or the Railroad Retirement Board for at least two years, or if you have end-stage renal disease or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease).
Like other parts of Medicare, there are rules concerning when you’re eligible and when you can sign up for coverage. If you’re already receiving retirement benefits before you turn 65, you may be automatically enrolled in Medicare Part A and/or Part B the month that you turn 65. You’re also automatically enrolled in Medicare if you’ve been receiving Social Security or Railroad Retirement Board disability benefits for at least two years; you’ll be automatically enrolled in the 25th month of disability benefits. Those who qualify for Medicare because of end-stage renal disease must manually sign up for Part B.
You can also sign up for Medicare Part B during the following periods:
You can enroll in Medicare Part B through Social Security in the following ways:
If you worked at a railroad, you can apply for Medicare through the Railroad Retirement Board, not Social Security. Contact the Railroad Retirement Board to enroll at 1-877-772-5772 (TTY users, call 1-312-751-4701); Monday through Friday, from 9AM to 3:30PM.
While some people may be eligible for premium-free Medicare Part A if they’ve worked at least 10 years (40 quarters) and paid Medicare taxes during that time, most beneficiaries must pay a monthly premium for Medicare Part B insurance unless they qualify for low-income assistance. This premium amount may change from year to year. Learn how much you may have to pay for your Medicare Part B premium here.
If your income falls above a certain threshold, you may have to pay a higher amount for Medicare Part B coverage. This is known as an Income Related Monthly Adjustment Amount (IRMAA), which is an extra amount you’ll pay on top of your monthly Part B premium. Social Security will contact you if this applies to you.
In addition, you may owe certain out-of-pocket expenses for Medicare Part B-covered services, including copayments, coinsurance, and the Part B annual deductible. Once you’ve met your yearly deductible, you’ll usually pay 20% of the Medicare-approved amount for most medical services and supplies. However, this may vary, depending on the specific service or equipment. See the most up-to-date Medicare Part B cost information.
Do you have questions about what Medicare Part B covers? Or perhaps you’re interested in finding additional benefits beyond Original Medicare, such as through a Medicare Advantage plan. If you’d like to discuss your Medicare coverage options with a licensed insurance agent, call eHealth today to learn about Medicare plan options that may work for your situation.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.