Here's What Medicare Part B Costs and Covers in 2019

Get the latest on the medical benefits Medicare provides.

Dan Caplinger
Dan Caplinger
Feb 23, 2019 at 9:15AM
Investment Planning

Those who are 65 or older rely on Medicare for the healthcare coverage they need. But it's tough to keep Medicare straight because of all the parts it has under a single umbrella. Traditional Medicare under Parts A and B is what many choose, but Part C Medicare Advantage coverage is available as an alternative, and Part D prescription drug coverage is an additional option.

But don't let the alphabet soup of coverage options confuse you. Instead, get a good sense of how all of Medicare's parts fit together by learning what you can about each type of coverage. Below, we'll look at Medicare Part B and the medical coverage that it offers.

Person in white coat holding stethoscope in a hallway with various people in it.

Image source: Getty Images.

The basics of Medicare Part B coverage

Medicare Part B covers medically necessary outpatient services and treatments. Qualifying events include what's necessary to deal with a disease or medical condition, including diagnosis, cure, prevention, or detection. Doctor visits are covered under Medicare Part B, but you'll find a wide range of services that include diagnostic tests, ambulance services, clinical research, durable medical equipment, mental health services, and even second opinions about key issues like surgery.

New Medicare participants get a one-time "Welcome to Medicare" preventive visit. There, a doctor will look at your medical history and work with you to gather key health information. You'll get a vision test, measurements of height, weight, blood pressure, and body mass index, and an assessment of depression risk. You'll also get a written plan in which your doctor will go through any necessary services you'll need to prevent larger health problems. After the first visit, you'll also qualify for annual checkups to maintain your wellness.

However, there are some things that Part B doesn't pay for. In particular, dentures and most dental care aren't covered, nor are hearing-aid examinations. You typically can't get coverage for eye examinations related to prescribing glasses or contact lenses.

It can be hard to know what's covered and what's not, but Medicare tries to make it easier. This tool on Medicare's website will tell you whether you can get coverage for a given test, service, or medical device. Your doctor or other healthcare provider should also be able to find out whether Medicare will cover their recommended treatment.

Costs for Medicare Part B

Medicare participants have to pay a monthly premium for Part B coverage. For 2019, the premium that most participants will pay is $135.50 per month. Only a small number of people will qualify for lower payments under what's known as the hold-harmless provision, because substantial increases to Social Security payments under cost-of-living adjustments have largely caught up with rising Medicare premiums.

However, if you're a high-income taxpayer, then you might have to pay higher premiums for their Part B coverage. Depending on your income, premiums can be as much as $428.60 per month.

For individuals with this income:

Or joint filers with this income:

Total monthly premium in 2018 will be:

$85,000 to $107,000

$170,000 to $214,000

$189.60

$107,000 to $133,500

$214,000 to $267,000

$270.90

$133,500 to $160,000

$267,000 to $320,000

$352.20

$160,000 to $500,000

$320,000 to $750,000

$433.40

Over $500,000

Over $750,000

$460.50

Data source: Medicare. Note: Married persons filing separately who lived together at any time during the year pay $433.40 if their income is $85,000 to $415,000, or $460.50 if their income is more than $415,000.

There are also deductibles and coinsurance amounts for Medicare Part B. In 2019, the Part B deductible is $185 per year. After you pay that amount out of pocket, Medicare starts providing coverage, and you'll only have to cover the 20% of your costs that Part B doesn't pay. In addition, with some preventive services, Part B pays everything.


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Stay healthy

For doctor visits and other outpatient care, Medicare Part B is an essential part of your financial protection plan. Given the high costs of healthcare, having Part B can be a lifesaver both healthwise and financially.