Medicare, the federal health insurance program primarily for individuals aged 65 and older, includes several components offering distinct coverage. Medicare Part B, commonly known as “medical insurance,” is integral to providing comprehensive healthcare services.

Medicare Part B covers a wide range of medical services, including doctor visits, outpatient care, durable medical equipment, and preventive services designed to maintain overall health.

Unlike Medicare Part A (hospital insurance), typically premium-free, Part B requires a monthly premium. In 2025, the standard monthly premium for Medicare Part B is $185.00. Higher-income individuals may pay increased premiums based on their income levels.

Low-income individuals may qualify for financial assistance through Medicare Savings Programs, potentially eliminating their Part B premiums.

What Does Medicare Part B Cover?

Medicare Part B covers two main types of medical services:

Medically Necessary Services

• Ambulance services
• Durable medical equipment (wheelchairs, walkers, hospital beds)
• Cardiac rehabilitation
• Chemotherapy
• Diabetes care supplies
• Physical therapy
• Diagnostic lab tests and imaging (X-rays, MRIs, CT scans, EKGs)
• Mental health counseling

Preventive Services

• Heart disease screenings
• Cancer screenings (cervical, vaginal, lung, breast, prostate, colorectal)
• Diabetes-related foot care
• Smoking cessation counseling and medications
• Vaccinations (flu shots, hepatitis B)
• HIV and hepatitis C screenings

Services Not Covered by Medicare Part B

Certain healthcare services fall outside Medicare Part B coverage:

• Long-term custodial care
• Routine dental care
• Eye exams for glasses
• Dentures
• Cosmetic surgery
• Hearing aids and related exams
• Routine foot care
• Most prescription medications (covered under Part D)
• Care received outside the U.S.

Supplemental insurance plans (Medigap) and Medicare Advantage plans typically help cover these gaps in Original Medicare.

How Much Does Medicare Part B Cost in 2025?

Monthly Premium

• Standard premium: $185.00 (2025)
• Higher-income beneficiaries face an Income-Related Monthly Adjustment Amount (IRMAA), resulting in premiums ranging from $259.00 to $628.90 monthly, depending on income.

Deductible and Coinsurance

• 2025 annual deductible: Subject to annual adjustments (2023 deductible was $226).
• After meeting the deductible, Medicare covers 80% of approved services, leaving a 20% coinsurance responsibility.

Medicare Part B Eligibility and Enrollment

Eligibility Criteria

• Individuals aged 65 and older who are U.S. citizens or permanent residents for at least five consecutive years
• Individuals under 65 receiving Social Security Disability or Railroad Retirement Board disability benefits for at least two years
• Individuals with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)

Enrollment Periods

• Initial Enrollment Period (IEP): Seven months around your 65th birthday
• Special Enrollment Period (SEP): After specific life events (loss of employer coverage)
• General Enrollment Period (GEP): January 1st to March 31st each year (late enrollment penalties may apply)

Expert Assistance for Medicare Part B

Navigating Medicare Part B can be complex. Plan Medicare’s licensed advisors in New York are here to help you understand your coverage options clearly and thoroughly.

Call us today at 516-900-7877 or schedule a consultation online to maximize your Medicare Part B benefits tailored specifically to your needs.

Frequently Asked Questions

What medications aren’t covered under Medicare Part B? Non-prescription drugs, vitamins, supplements, and most medications taken at home (covered under Medicare Part D).

Does Medicare Part B cover all costs? No, Medicare Part B covers 80% of medically necessary services after you meet the deductible, with a 20% coinsurance remaining.

What is the monthly cost for Medicare Part B in 2025? The standard monthly premium for Medicare Part B in 2025 is $185.00, with higher premiums for high-income earners.