Medicare Part B in California

Medicare Part B,along with Part A, was part of the Original Medicare insurance offered to enrollees. California Medicare Part B planshave since been portioned from Part A and provide different health care coverage. There is a monthly Medicare Part B cost associated with enrollment as well as deductibles and coinsurance payments required for certain covered services. Understanding the coverage provided by Medicare Plan B is beneficial before signing up, as many Medicare applicants opt to delay enrollment.

What is California Medicare Part B?

Medicare Part B is also known as medical insurance, which can be confusing since Medicare Part A is known as hospital insurance. Medicare Part B plans cover services performed by doctors and health care professionals, including inpatient and outpatient care. Medicare Plan B also covers supplies and medical equipment needed to treat health conditions. For the cost of Medicare Part B plans, enrollees will also have select outpatient prescription drug and ambulance service coverage.

For comprehensive information about Medicare Part B covered services, download our California guide here.

How to Enroll in Medicare Part B Plans in California

Medicare Plan B enrollment may be automatic for some residents. Like Part A, Medicare Part B plans automatically send notification letters of registration into the insurance program to benefactors of certain retirement and disability benefits. Automatic enrollees of Medicare Part B can waive or delay coverage when they are initially eligible, although they may be subject to late enrollment penalties. If you already have coverage through an employer, you may choose to delay your Part B enrollment.

If you are not eligible for automatic registration, then you will need to submit an application to enroll. You should sign up for Medicare Plan B during your Initial Enrollment Period, which is when you are first eligible for Medicare insurance. If you deterred signing up for a Medicare Part B plan at that time, you will need to wait until the General Enrollment Period. You can apply for Plan B Medicare by calling or visiting your local Social Security office as well as signing up online.

To learn more about enrollment periods, including special enrollment times for California residents, download our state guide.

What does Medicare Part B cost and cover in California?

Medicare Part B premiums vary based on your income as well as if you collect Social Security benefits. If you are signing up for a Medicare Part B plan after deterring coverage since your Initial Enrollment Periods, your monthly premium could increase 10 percent for each year you were late enrolling. Other Medicare Part B costs to consider are the deductible and coinsurance for medical services and supplies.

The amount of your monthly Medicare Part B premium will depend on your annual household income. Enrollees categorized as higher earners will pay more accordingly, until reaching the maximum. The tiered threshold is different for applicants applying jointly (married) or individually. Household tiered brackets are broken down as:

  • Less than $85,000 (individual) or $170,000 (joint)
  • $85,001 to 107,000 or $170,001 to 214,000
  • $107,001 to160,000 or $214,001 to 320,000
  • $160,001 to 214,000 or $320,001 to 428,000
  • More than $214,000 or $428,000

The average Medicare Part B premium is around $134 per month but can be less or more depending on income and benefits. Social Security beneficiaries who have their Medicare Part B premiums deducted from received benefits will also have a lower rate. Those with very low incomes bay be dual-eligible to receive Medicare and Medicaid (Medi-Cal) insurance coverage. California pays the premium amount for dual-eligible enrollees.

The deductible for Medicare Part B plans are fixed for the year. Unlike Part A, which resets the deductible for each benefit period (can be multiple in a year), Plat B has one annual deductible. The Medicare Part B deductible is the same for each participant and does not fluctuate based on income. Part B deductible does not apply for some preventative service and screenings.

After paying the yearly deductible for Medicare Plan B, you will pay a percentage of the Medicare-approved amount for doctor health services, durable medical equipment and outpatient therapy. Medicare Part B will completely cover approved clinical laboratory and home health services. Some outpatient services require a co-pay instead of coinsurance. A co-payment is a fixed amount for a service or product. You will not be required to make any co-payments for home health services or for a quarterly depression screening.

For in-depth Medicare information and specific amounts, refer to our comprehensive guide.

Medicare Part B Enrollment Penalty for California Residents

Not all who deter Medicare Plan B insurance will incur a 10 percent increase in premiums. Penalty costs for Medicare Plan B will be waive if you had adequate coverage, such as employer-provided health insurance. However, employers must have more than 20 employees and a group health plan. Active-duty service members with TRICARE also do not need to enroll in Part B when initially eligible to avoid late enrollment penalties.

What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.

Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.