Navigating Medicare Part B: Medical Coverage, Costs, and Avoiding Penalties

April 21st, 2025

Navigating Medicare Part B requires a thorough understanding of its coverage, which includes outpatient care, doctor visits, preventive services, and more. To help you make the most of these benefits, seeking advice from a seasoned Medicare Agent is highly recommended. Below, we break down the key aspects of Medicare Part B, including deductibles, co-pays, and premiums:

What Medicare Part B Covers

• Doctor visits and outpatient care.
• Preventive services (e.g., screenings, vaccines).
• Durable medical equipment (e.g., wheelchairs, walkers).
• Mental health services.​Medicare
  

Costs Associated with Part B

• Monthly Premiums: In 2025, the standard premium is $185. Varies based on your income.
• Annual Deductible: $257 in 2025.
• Coinsurance: Typically 20% of the Medicare-approved amount for services. Medicare.gov

Gaps in Coverage

• No out-of-pocket maximum.
• Limited coverage for dental, vision, and hearing services.
• Potential high costs for frequent medical services.​

How to Fill the Gaps

• Medicare Supplement also known as Medi-gap policies, to cover coinsurance and deductibles. Plans and coverage vary.
• Medicare Advantage Plans (Medicare Part C) offering additional benefits.
• Supplemental dental, vision, and hearing insurance.​ 
• LearnhowMedigapswork

Enrollment Periods and Penalties

• Initial Enrollment Period: 7-month window around your 65th birthday.
• Special Enrollment Periods for qualifying events.
• General Enrollment Period: January 1 – March 31 each year.
• Late Enrollment Penalty: An additional 10% for each 12-month period you were eligible but didn't enroll, applied to your monthly premium. MedicarePartBLatePenalties

Conclusion

• Avoid Enrollment penalties at all costs, they stay with you for your entire Medicare life.
• Once you are on a fixed income, it is important to understand your out of pocket risks to have a worry free retirement.

Kim & Co. Agency and their Medicare Agents will provide a no costs consultation to help navigate through the maze of Medicare.​