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What are Your Potential Out-of-Pocket Expenses with Medicare Part B?

Written by Evens Stevenson

Seniors spend thousands and thousands of dollars every year on doctor’s visits, hospital trips, treatments, and much more. Healthcare is one of the biggest portions of most enrollee’s budgets. Without having coverage, it could quickly eat away at savings accounts and ruin retirement dreams.

While Medicare Part B covers a great deal of medical expenses for its enrollees, there are certain out-of-pocket costs that individuals should be aware of. Medicare Part BKnowing these expenses can help individuals to anticipate their potential yearly medical related costs. If you’re new to Medicare, or about to enroll in Medicare, you’ll need to know what type of expenses you’re going to be paying. There are thousands of enrollees that get caught off guard by expenses that did not anticipate.

First, all enrollees in Medicare Part B are required to pay a monthly premium for this coverage. In most cases, individuals will pay the standard amount. In 2016, this amount is $121.00 per month. However, for those who are in higher income brackets, the Medicare Part B monthly premium could be more – and, the amount that is due could change each year, depending on the individual’s income.

For example, the Medicare Part B premium that is due for 2016 will be based upon one’s income that was attained in 2014, as well as by how an enrollee filed his or her annual tax return. The chart below outlines the amount of monthly Medicare Part B premium that would be due based upon one’s 2012 income and tax filing status.

Annual Income Amount and File Individual Tax Return

Annual Income Amount and File Joint Tax Return

Annual Income Amount, Married and File Separate Tax Return

Medicare Part B Monthly Premium Due

$85,000 or less

$170,000 or less

$85,000 or less


Above $85,000 up to $107,000

Above $170,000 up to $214,000

Not applicable


Above $107,000 up to $160,000

Above $214,000 up to $320,000

Not applicable


Above $160,000 up to $214,000

Above $320,000 up to $428,000

Above $85,000 and up to $129,000


Above $214,000

Above $428,000

Above $129,000



For those who do not apply for Medicare Part B when they are initially eligible to do so, they may also pay an additional premium as a “late enrollment penalty.” Every year you don’t enroll in Medicare Part B, you could be facing a 10% increase in your Part B premiums. This makes it easy to see why it’s vital that you enroll in the program on time.

Additional Medicare Part B Expenses

In addition to Medicare Part B premium expenses, enrollees also have costs that occur when care is received. For example, each year, enrollees will be required to pay a Medicare Part B annual deductible. In 2016, the deductible for Medicare Part B is $166.00.

While Medicare Part B provides coverage for a wide range of medical and doctors’ services, there are also many “gaps” in what it will and will not pay. This can leave participants with a great deal of yearly out-of-pocket expenses like copayments and coinsurance. These costs can become quite steep – as even items like ambulance services and doctor visits can truly add up over time.

For items that are not covered, it could be helpful to purchase a Medicare Supplement insurance policy. These plans can help to fill in the gaps in coverage that are left by Medicare – in turn, potentially saving thousands of dollars per year to Medicare enrollees.

Unlike when you’re enrolling in Medicare, you’ll have a few options when shopping for Medigap insurance. In fact, you have ten options.

They are all named after letters of the alphabet, from A, all the way to F. The most basic of the plans is Plan A, which covers the least amount of left over expenses. Medicare Supplement Plan F  covers all of the expenses that aren’t paid for by Original Medicare.

When you’re looking at the options, you might be confused trying to pick a plan.

First, review your budget. Can you afford a Plan F or does your finances only allow enough room for a Plan A?

You’ll have to consider your health and family history. How is your health? If you’re in great physical health and have a positive family history, you can consider getting one of the most basic supplemental insurance policies that will only pay for some of the out-of-pocket expenses.

You also need to look at all of the different options that you have. The ten different supplemental plans are not your only options for getting additional coverage. You have to weigh all of your options like Medicare Advantage. All of your options are going to have advantages and disadvantages.

Medicare Supplement insurance policies can provide Medicare enrollees with the peace of mind in knowing that even many of the non-Medicare covered services will be paid for – allowing them to concentrate on wellness, rehabilitation, and achieving overall better health and peace of mind.  If you are interested in learning more about Medicare supplements or getting a set of Medigap quotes use the form on this page.

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