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Medicare Part B Explained

What is Medicare Part B?

What does Part B cover?

  • Doctor and other health care provider services
  • Outpatient surgery
  • Lab and x-ray services
  • Ambulance services
  • Preventive services
  • Durable medical equipment like prosthetics, wheelchairs, and hospital beds

Services that are not covered by Medicare, but are covered by Medicare Advantage plans include:

  • Routine hearing, dental, and vision exams.
  • Hearing aids or glasses (except for glasses after cataract surgery).
  • Emergency assistance while traveling outside the U.S.
  • Fitness club membership.
  • Long-term care (such as a nursing home).
  • Prescription drug coverage.

How much does Medicare Part B cost?

Part B requires you to pay a monthly premium, calculated based on your adjusted gross income, along with a yearly deductible before coverage begins. You are also responsible for paying part of the costs that Part B does not cover.

Your costs include:

  • Your Medicare Part B monthly premium, if applicable
  • Yearly deductible (paid before Medicare begins paying)
  • Coinsurance (percentage of the cost that Medicare does not pay)

When am I eligible for Medicare Part B?

You can enroll in Medicare Part B if:

  • You are age 65 or older, or
  • You are under age 65 with certain disabilities, or
  • You have permanent kidney failure requiring dialysis.

How do I get Medicare Part B?

If you already get benefits from Social Security, you'll get Medicare Parts A and Part B automatically when you're first eligible and don't need to sign up. Medicare will send you a "Welcome to Medicare" packet 3 months before you turn 65. You can also contact the Social Security Administration to sign up for Original Medicare. You can visit their website at www.ssa.gov. Or call toll-free 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.

Next Steps

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal.

Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health Inc. and/or its subsidiaries and/or affiliates in the USA and/or other countries.
UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 through March 31:
seven days a week from 8 a.m. to 8 p.m.

April 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 through Dec. 31:
seven days a week from 8 a.m. to 8 p.m.

Jan. 1 through Sept. 30:
Monday through Friday: 8 a.m. to 8 p.m.
Saturday: 9 a.m. to 3 p.m.

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Last Updated: 10/01/2020
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