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Everything You Need to Know About Medicare Part B

Medicare Part B is health insurance that helps you to pay for doctor visits, outpatient services, and other services, including laboratory tests and surgery. It also covers supplies, such as wheelchairs, walkers, and other supplies that are considered as necessary for the treatment of an illness.

What Services Does Part B Cover Specifically?

  • Clinical Research Studies: Medicare covers the cost of research for medications to treat cancer and other illnesses. You might have to pay for a percentage of these services. Find out before participating in these kinds of studies.

    Everything You Need to Know About Medicare Part B
    | Foto: THINKSTOCK
  • Ambulance Services: It covers ambulance transportation via land or air, as well as helicopter under certain circumstances and when your life is at risk if you were to be transported in another way.

  • Durable Medical Equipment (DME): This includes air-fluidized beds, blood sugar monitors and test strips, canes, wheelchairs, crutches, oxygen equipment, suction pumps, and infusion pumps, among others.

  • Mental Health: For these services, find out exactly what is covered and if it will have a cost for you. Coverage offered by Medicare is both for hospitalization, outpatient and partial hospitalization.

  • Getting a second opinion prior to a surgery: This is one of your rights as a patient, and Medicare covers it, although they do recommend that you don’t look for a second opinion in the event emergency surgery is necessary.

  • Limited prescription medication for outpatient treatment: It covers a limited amount of prescription medication for outpatient care under certain conditions. In general, the medication covered by Part B are medications that you would not receive, like those given at a doctor’s office or a visit to an external office. Medications not covered by Part B may be covered by a Medicare Prescription Drug Plan (Part D).

The official site recommends that you always find out if Medicare covers a certain item, service or supply.

Do I Have to Enroll or is It Automatic?

Enrollment in both Medicare Part A and Part B is automatic if:

  • You receive Social Security or Railroad Retirement Board (RBR) benefits. 

  • You are under the age of 65 and have a disability. 

  • You have Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease.

  • You live in Puerto Rico and receive Social Security or RBR benefits

In all of these cases, you will receive your red, white, and blue Medicare card 3 months before your 65th birthday or 25th month of disability.

You should enroll (meaning you don’t meet the requirements for automatic enrollment) if:

  • You do not receive Social Security retirement or Railroad Retirement Board benefits (for example, if you are still working).

  • You are eligible for Medicare because you have end-stage renal disease (ESRD).

  • You live in Puerto Rico and want to enroll in Part B.

When Should I Enroll?

If you didn’t enroll for Medicare Part B when you became eligible, you might have to enroll during the open enrollment period. This runs from January 1 to March 31 every year. During this period, you can enroll in Medicare Part B at a local Social Security Office. If you received benefits from the Railroad Retirement Board (RRB), call your local RRB office or 1-877-772-5772. Your Medicare Part B coverage will begin on July 1 of the year you enroll.

Important: Except for in special cases, the cost of Medicare Part B will increase by 10% for each 12-month period in which you were eligible for Medicare Part B but did not enroll. You will have to pay this penalty as long as you have Medicare Part B.

If you already have Medicare Part A and need Part B, you can enroll in Part B at your local Social Security office, or by calling 1-800-772-1213 (TTY users should call 1-800-325-0778).

For more information about enrolling in Medicare Part B, or if you or your spouse are still employed, visit Your enrollment may be delayed because you are your spouse are still employed, but the open enrollment period will not affect you until you are both retired.

If you are retired military or the spouse or dependent child of a retired veteran, or a sponsor on active duty, visit

How Do I Enroll in Medicare Part A and B?

  • Send your request online to Social Security

  • Visit a local Social Security office. 

  • Call Social Security at 1-800-772-1213.

  • If you worked for a railroad company, contact the RRB at 1-877-772-5772.

Medicare is managed by the Medicare Services Centers and Medicaid (CMS). Social Security works in collaboration with the CMS to enroll in Medicare.

Do I have to pay for Medicare Part B?

Most people paid the premium for Part B of $104.90 during every month of 2013, and the deductible per year was  $147 in 2013.

Some people may automatically receive Part B. Now, if you don’t qualify to automatically receive Medicare, you are required to enroll when you meet eligibility requirements. If you don’t enroll at that time, you might have to pay a fine for late enrollment.

If your gross adjusted and modified income reported on your tax return to the IRS from two years ago (which is the information from the most recent tax return provided to Social Security by the IRS) is over a certain amount, you might pay more.

Social Security will notify those required to pay more due to their income. The amount you pay each month can vary depending on your income. If you have to pay a higher premium for Part B and don’t agree with this (for example, if your income decreased), contact Social Security.

If your income is above a certain amount, you might have to pay a higher premium for Part B. For more information visit www.Medicare.gove.

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