what is medicare part b

Medicare Part B: What Does it Cover & When to Enroll? (2025)

What is Medicare Part B?

Medicare Part B (medical insurance) is part of Original Medicare. Original Medicare is comprised of Medicare Part A and Medicare Part B. It’s a federal health insurance program designed to provide and reduce the cost of health care services in the United States. If you are eligible for Medicare Part A, then you can also enroll in Original Medicare Part B.

Am I Eligible for Medicare Part B?

You are eligible for Original Medicare, including Medicare Part B, if you meet one of three criteria:

  • You’re aged 65 or older.
  • You’re younger than 65 with eligible disabilities by the Social Security Administration.
  • You have Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).

What Does Medicare Part B Cover?

Medicare Part B covers preventative services and medically necessary services. This includes care to prevent an illness or detect it at an early stage – and services or supplies needed to diagnose or treat a medical condition.

Part B Medicare covers, but is not limited to:

Many tests, items, and services are not covered by Medicare Part B. These include routine dental, vision, and hearing care, such as check-ups, eyeglasses or contact lenses, hearing aids, dental extractions, and dentures.

We recommend asking your provider if your Medicare plan will cover your medical service or procedure.

Curious about Medicare Part B’s costs? Read “Cost of Medicare Part B Premium, Deductible & More.”

Need Help Deciding The Right Medicare Coverage For You?

  • Free, unbiased service
  • Compare all major plans and carriers
  • Local, licensed insurance agents with 25+ years of experience
Speak with a local licensed insurance agent
David Luna Co-founder and
Licensed Insurance Agent
(623) 223-8884 (TTY: 711) M-F 9am - 5pm
There's no obligation to enroll

When to Apply for Medicare Part B

Know your Initial Enrollment Period

You are first eligible for Medicare during your Initial Enrollment Period. The Initial Enrollment Period begins three months before your 65th birthday, the month you turn 65, and ends three months after your 65th birthday. You have this seven-month window to enroll in Medicare.

Medicare eligibility quiz

Should you miss your Initial Enrollment Period, you can enroll in Medicare Part B during the General Enrollment Period (January 1 – March 31), or a Special Enrollment Period, if you qualify.

Instances when you’re automatically enrolled in Original Medicare

  • When you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Parts A & B starting the first day of the month you turn 65.
  • If you are younger than 65 and have an eligible disability from the Social Security Administration, the Initial Enrollment Period does not apply to you. You will automatically receive Medicare Parts A & B after receiving disability benefits from the Social Security Administration for 24 months.
  • Have Amyotrophic Lateral Sclerosis or End-Stage Renal Disease? You’ll automatically get Medicare Part A and Part B the month your disability benefits begin.

Can I Delay Enrolling in Medicare Part B?

You can turn down or delay Medicare Part B enrollment. If you decide to enroll later on, your coverage could be delayed. You may pay a late enrollment penalty if you don’t have creditable coverage during that time.

Agent tip:

“If you decline Part B and don’t have creditable coverage, you could pay a late enrollment penalty that lasts as long as you have Medicare Part B.“

This penalty will be added to your Part B premium for as long as you have Medicare Part B. The penalty could cause your premium to increase up to 10 percent for each year you were eligible for Part B and chose not to sign up – unless you qualify for a Special Enrollment Period.

Speak with a local licensed Connie Health agent to ensure you enroll in Medicare Part B at the right time—call (623) 223-8884.

Not Yet Retired?

Suppose you are not retired and receive benefits from the Social Security Administration or Railroad Retirement Board at least four months before turning 65. You’ll need to sign up with the Social Security Administration to get Medicare Part A.

If you have private health insurance through your or your spouse’s employer, you can delay Medicare Part B until you retire and receive Social Security benefits.

Considerations for delaying signing up for Medicare Part B:
  • Most people pay a Medicare Part B premium. Determine whether it’s more cost-effective to be on Medicare Part B on your or your spouse’s private health insurance coverage.
  • Your employer-based health insurance company may offer similar coverage to Part B medical insurance.
  • You should check with your group health insurance plan administrator about how your health plan works with Medicare coverage – see what happens once you’re Medicare eligible.

End-Stage Renal Disease

You can enroll in Parts A & B if you’re eligible for Medicare because of End-Stage Renal Disease. You can choose whether or not to sign up for Part B. However, you’ll need Parts A & B to cover certain services under Medicare, including dialysis and kidney transplant services.

Need Help Deciding The Right Medicare Coverage For You?

  • Free, unbiased service
  • Compare all major plans and carriers
  • Local, licensed insurance agents with 25+ years of experience
Speak with a local licensed insurance agent
David Luna Co-founder and
Licensed Insurance Agent
(623) 223-8884 (TTY: 711) M-F 9am - 5pm
There's no obligation to enroll

How to Sign up for Medicare Part B

Here are the four ways to apply for Original Medicare (Medicare Parts A & B) through the Social Security Administration. Already enrolled in Medicare Part A? Skip to the next section.

Choose the most convenient method for you:

  1. Apply online at Social Security Medicare Benefits.
  2. Visit your local Social Security office.
  3. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778). Representatives are available Monday through Friday, from 8:00 AM to 7:00 PM, in all U.S. time zones.
  4. Call the Railroad Retirement Board at 1-877-772-5772 if you worked for a railroad.
  5. Call (623) 223-8884 and speak with a local licensed Connie Health agent who can refer you to the best place to apply and help you with your Medicare plan options.

Unfortunately, Medicare Part B doesn’t offer a maximum out-of-pocket. Once enrolled in Part B, explore supplemental Medicare insurance to protect yourself from high out-of-pocket costs and potential medical debt.

Your options include a Medicare Advantage plan or Medicare Supplement plan (Medigap). Call a local licensed Connie Health agent at (623) 223-8884 to review your plan options.

Already Enrolled in Medicare Part A?

Already enrolled in Medicare Part A but previously declined Medicare Part B? You can enroll during your Initial Enrollment PeriodGeneral Enrollment Period, or Special Enrollment Period. The timing depends on why you initially declined to enroll in Medicare Part B.

If you’d like help enrolling in Medicare Part B or determining if now is the right time for you to enroll, a local licensed Connie Health agent can help. We’ll review your situation and provide the next steps to help you avoid late enrollment penalties—call (623) 223-8884.

Read more about Medicare Part B’s costs: “Cost of Medicare Part B Premium, Deductible & More.”

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Frequently Asked Questions

What does Medicare Part B cover?
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Original Medicare Part B covers, but is not limited to:

  • Visits to your doctor and specialists (orthopedic, cardiology, radiology, and others)
  • Mental health services (inpatient, outpatient, and partial hospitalization)
  • Screenings for common medical conditions (mammogram, colonoscopy, diabetes, and more)
  • Preventative care, including annual wellness checkups
  • Vaccinations (flu, pneumococcal, Hepatitis B, and more)
  • Clinical research
  • Ambulance services
  • Durable Medical Equipment (DME) (wheelchairs, walkers, blood pressure monitors, CPAP machines, and more)
  • Limited outpatient prescription drugs
  • Medically necessary services and supplies.

Many tests, items, and services are not covered by Medicare Part B. These include routine dental, vision, and hearing care – such as check-ups, eyeglasses or contact lenses, hearing aids, dental extractions, and dentures.

Are you wondering if Original Medicare Part B covers a service or procedure? Call and speak with a local licensed Connie Health agent at (623) 223-8884. We can help you determine your current coverage and whether a Medicare Advantage plan could provide you better coverage at a lower cost.

What is Medicare Part B?
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Medicare is a federal health insurance program designed to provide and reduce the cost of health care in the United States. Medicare is available to people aged 65 and older, younger individuals with disabilities, and people with End-Stage Renal Disease.

Medicare is divided into several parts, with Medicare Part A covering hospital insurance and Medicare Part B covering medical insurance. If you are eligible for Medicare Part A, you can also enroll in Original Medicare Part B.

Medicare Part B is optional and covers two types of services:

  • Medically necessary services: Services or supplies needed to diagnose or treat your medical condition that meet accepted medical practice standards.
  • Preventive services: Health care to prevent illness or detect it at an early stage, when treatment is most likely to work best.

Opting for Medicare Part B is a choice, but for many, it’s a crucial aspect of their healthcare plan, providing broader protection against the costs of medical care.

If you’re not enrolled in Medicare Part B, and you’re wondering if you need to enroll or if now is the right time, a local licensed Connie Health agent can help. Call (623) 223-8884 and speak with an agent to ensure you enroll in the right Medicare coverage for your health and budget needs.

How to apply for Medicare Part B?
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There are four ways to apply for Original Medicare (Medicare Parts A & B) through the Social Security Administration.

Choose the most convenient method for you:

  1. Apply online at Social Security Medicare Benefits.
  2. Visit your local Social Security office.
  3. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778). Representatives are available Monday through Friday, from 8:00 AM to 7:00 PM, in all U.S. time zones.
  4. Call the Railroad Retirement Board at 1-877-772-5772 if you worked for a railroad.

Unfortunately, Medicare Part B doesn’t offer a maximum out-of-pocket. Once enrolled in Part B, explore supplemental Medicare insurance to protect yourself from high out-of-pocket costs and potential medical debt.

Your options include a Medicare Advantage plan or Medicare Supplement plan (Medigap). Call a local licensed Connie Health agent at (623) 223-8884 to ensure your Medicare coverage is right for your health and budget needs.

How much is Medicare Part B?
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Costs for Medicare Part B include a monthly premium, an annual deductible, and coinsurance.

The standard Medicare Part B premium is $185.00 in 2025. And the Medicare Part B deductible is $257.

Once you pay your annual Part B deductible, cost-sharing begins. Original Medicare Part B will cover 80% of Medicare-approved costs, while you would pay the 20% coinsurance for all Medicare-approved expenses. There is no cap on out-of-pocket costs, so most Medicare beneficiaries enroll in either a Medicare Supplement or Medicare Advantage plan.

If you want help determining if a Medicare Supplement or Medicare Advantage plan is right for your health and budget needs, call (623) 223-8884 and speak with a local licensed Connie Health agent. We can help you weigh your options.

What is Medicare Part B monthly premium 2025?
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The standard Medicare Part B monthly premium for 2025 is $185.00. This excludes any additional costs you may incur from an Income Related Monthly Adjustment Amount (IRMAA) or penalties for Medicare Part B late enrollment.

If you need help determining whether you will incur an income-related monthly adjustment amount and your actual monthly premium for Medicare Part B, call (623) 223-8884 and speak with a local licensed Connie Health agent. We’re here to support you throughout your Medicare journey.

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Read more by David Luna

I am a Spanish-speaking Arizona Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2005. I am a Marine Corps Veteran & former police officer. I enjoy watching football and basketball but hold family time in the highest regard.

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