What does Medicare Part B premium pay for?

Asked by: Jenifer Fadel  |  Last update: October 29, 2025
Score: 4.9/5 (59 votes)

Medicare Part B helps cover medical services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. Part B is optional. Part B helps pay for covered medical services and items when they are medically necessary.

What does Medicare Part B Premium cover?

Medicare Part B Premium and Deductible

Medicare Part B covers physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.

What expenses will Medicare Part B pay for?

Part B covers things like:

Durable medical equipment (DME) Limited outpatient prescription drugs. Mental health & substance use disorders. Oxygen equipment & accessories.

Does everyone pay $170 for Medicare Part B?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

What does Medicare Part B help pay for?

Part B (Medical Insurance)

Covers certain doctors' services, outpatient care, medical supplies, and preventive services. premiums through a Medicare Savings Program.

Social Security Checks: February 2025 Payment Schedule Dates Update

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What does Medicare Part B not pay for?

Medicare Part B does not pay for some services that fall under the coverage of other parts. Examples include inpatient hospital services, which Part A funds, and most prescription medications, which Part D funds. Medicare regularly evaluates which services Part B will cover.

Why is Social Security no longer paying Medicare Part B?

There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.

How do I avoid paying Medicare Part B?

You may refuse Part B without penalty if you have creditable coverage, but you have to do it before your coverage start date. Follow the directions on the back of your Medicare card if you want to refuse Part B.

Is Medicare Part B free if you're over 65?

You have to pay a monthly premium for Medicare Part B (medical insurance). If you already have other health insurance when you become eligible for Medicare, you may wonder if it's worth the monthly premium costs to sign up for Part B. The answer varies with each person and the kind of other health insurance you have.

Does Medicare pay 100% on Part B?

Medicare Part B coinsurance

Coinsurance is a cost-sharing term that means insurance pays a percentage and you pay a percentage. With Medicare Part B, you pay 20 percent of the cost for the services you use. So if your doctor charges $100 for a visit, then you are responsible for paying $20 and Part B pays $80.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

Do I need part B if I have other insurance?

You can enroll in Medicare Part B if you have other insurance, but you don't have to. However, depending on your other insurance, it may benefit you to have both. This depends on the cost of your other insurance and how it works with Medicare.

Does Medicare Part B cover dental?

For Part B-covered dental services, you pay 20% of the Medicare-approved amount after you meet the Part B deductible. If you get the covered service in an outpatient hospital or other facility setting, you'll also pay a copayment to the facility.

Does everyone pay the same Medicare Part B premium?

If we determine you're a higher-income beneficiary, you'll pay a larger percentage of the total cost of Part B based on the income you normally report to the Internal Revenue Service (IRS). You'll pay monthly Part B premiums equal to 35%, 50%, 65%, 80%, or 85% of the total cost, depending on what you report to the IRS.

How do you qualify for $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

What does Social Security extra help pay for?

The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.

What does Medicare Part B not cover?

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams. Cosmetic surgery.

How much is deducted from social security for Medicare Part B?

Most people pay the standard Part B monthly premium amount ($185 in 2025). Social Security will tell you the exact amount you'll pay for Part B in 2025.

Does Medicare Part B pay for doctor visits?

Medicare Part B pays for outpatient medical care, such as doctor visits, some home health services, some laboratory tests, some medications, and some medical equipment. (Hospital and skilled nursing facility stays are covered under Medicare Part A, as are some home health services.)

Can I get part B Medicare for free?

Part B is a voluntary program that requires the payment of a monthly premium for all parts of coverage. Eligibility rules for Part B depend on whether a person is eligible for premium-free Part A or whether the individual has to pay a premium for Part A coverage.

Why is Medicare B so expensive?

Medicare costs, including Part B premiums, deductibles and copays, are adjusted based on the Social Security Act. And in recent years Part B costs have risen. Why? According to CMS.gov, “The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs.

Can I drop my employer health insurance and go on Medicare Part B?

Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).

Who is exempt from paying Medicare Part B premiums?

Enrollees who have Medicaid, employer-sponsored health coverage, or retiree health benefits from an employer generally don't have to pay the full Medicare Part B deductible, as the other coverage picks up some or all of the cost (this varies depending on the plan).

How much will Medicare Part B cost in 2025 for seniors?

The Centers for Medicare & Medicaid Services (CMS) has announced that the standard monthly Part B premium will be $185.00 in 2025, an increase of $10.30 from $174.70 in 2024.

Why would you decline Medicare Part B?

In most cases, you should only decline Part B if you have group health insurance from an employer you or your spouse is actively working at, and that insurance is primary to Medicare, meaning it pays before Medicare does.