You’re Paying for Part B Every Month—Here’s How to Make It Worth It

Key Takeaways

• You’re paying a monthly premium for Medicare Part B in 2025, and understanding how to fully use those benefits can help you avoid unnecessary out-of-pocket expenses.

• Knowing the services Part B covers, when to use them, and how to coordinate them with other benefits—like preventive services or supplemental insurance—can make your monthly premium go much further.

What Medicare Part B Actually Covers

Medicare Part B is not optional if you want full outpatient coverage—it’s essential. In 2025, the standard monthly premium is $185, and for that cost, you’re entitled to a wide range of healthcare services.

Medical Services Covered:

• Doctor’s visits (primary care and specialists)

• Outpatient care at hospitals or clinics

• Preventive screenings like mammograms, colonoscopies, diabetes screenings, and more

• Mental health services including therapy, psychiatric evaluations, and outpatient treatments

• Durable Medical Equipment (DME) such as wheelchairs, walkers, and oxygen equipment

• Some home health care services if you’re homebound

What’s Not Covered:

• Most dental, vision, and hearing care

• Long-term custodial care

• Prescription drugs (those fall under Part D unless you have additional coverage)

The key to making Part B worth it lies in how you use the services it does cover.

Use Preventive Services—They’re Already Paid For

One of the most underutilized benefits of Part B is preventive care. These services are typically covered in full if you meet the eligibility criteria and see a provider who accepts Medicare assignment.

What to Schedule Annually:

• Annual Wellness Visit (different from a physical exam)

• Cardiovascular disease screening

• Mammograms and Pap tests for women

• Prostate cancer screenings for men

• Flu, pneumonia, hepatitis B, and COVID-19 vaccines

These visits not only help prevent illness but can catch health problems early when they’re easier—and cheaper—to treat.

Coordinate Part B With Other Coverage

Many Medicare enrollees also have other forms of coverage. Whether it’s a retiree plan, union plan, Medicaid, or a Medigap policy, it’s important to understand how your plans work together.

Things You Should Know:

• Medigap (Medicare Supplement Insurance) helps cover Part B copays and coinsurance.

• Employer coverage might pay first or second depending on your size of employer and whether you’re still working.

• Medicaid may cover your Part B premium if you qualify, and can also reduce out-of-pocket costs.

You need to coordinate these options smartly to avoid duplicating coverage—or worse, missing gaps.

Understand Out-of-Pocket Costs and How to Manage Them

Even with Part B, you’re still responsible for:

• Annual deductible of $257 in 2025

• 20% coinsurance on most covered services

But you can take steps to reduce these expenses:

• Always choose doctors and facilities that accept Medicare assignment to avoid extra charges.

• Consider a Medigap plan if you expect frequent outpatient care.

• Keep track of what’s preventive and what’s diagnostic—diagnostic services often come with a 20% coinsurance.

Knowing when and how these costs apply helps you avoid surprise bills.

Take Full Advantage of Mental Health Coverage

Mental health is part of your Part B coverage, but many people overlook it. If you’re experiencing depression, anxiety, or stress-related conditions, you can receive:

• Outpatient therapy sessions

• Psychiatric evaluations and medication management

• Alcohol misuse screenings and counseling

Mental health services are subject to the same 20% coinsurance, but they’re worth using—especially if stress or mood changes are affecting your daily life.

Know the Rules Around Telehealth in 2025

Medicare continues to cover telehealth in 2025, a benefit expanded during the COVID-19 pandemic and retained due to its success.

What’s Included:

• Primary care appointments

• Mental health therapy

• Follow-up specialist visits

These are billed under Part B just like in-person services. Using telehealth can save travel time, help you stick to care plans, and reduce exposure to illnesses in waiting rooms.

Don’t Miss the Annual Enrollment Window for Supplementary Plans

Each year from October 15 to December 7, you can make changes to your Medicare coverage—including how you manage your Part B expenses.

If your current plan isn’t helping you make the most of Part B, this is your chance to:

• Enroll in or change a Medigap plan

• Adjust your Part D drug plan, which can indirectly affect how much you spend under Part B (e.g., medication management visits)

• Add or drop other supplemental coverage

Use this time to assess your needs and talk with a licensed agent listed on the website.

Use DME Coverage Strategically

Durable Medical Equipment (DME) is another often-missed benefit of Part B. If you’ve had recent surgery, experienced a fall, or are dealing with a chronic illness, you might qualify for:

• Wheelchairs, canes, walkers

• Hospital beds

• Home oxygen therapy

• Blood sugar monitors and test strips (if you have diabetes)

This benefit requires that your doctor write a prescription and that the supplier is enrolled in Medicare. If done right, it can significantly improve your quality of life without a huge out-of-pocket burden.

Learn the Difference Between Observation and Admission

When you go to the hospital, you may be under “observation” status, which is billed under Part B—not Part A.

This can surprise people expecting full inpatient coverage. Here’s how to be smart about it:

• Ask if you’ve been officially admitted or just observed

• Know that observation services mean you’ll pay 20% of the cost, just like other Part B outpatient services

• Be cautious about relying on hospital stays to trigger skilled nursing facility coverage unless you’re formally admitted for three consecutive days

Being informed can help you question billing classifications and save money.

Use Medicare’s Preventive Counseling Options

In addition to screenings, Part B covers counseling for:

• Smoking cessation

• Alcohol misuse

• Obesity and diet-related concerns

• Advance care planning

These aren’t just for those in crisis. If you’re making lifestyle changes or facing chronic conditions, these services are proactive steps to improve outcomes and lower long-term costs.

Make Your Annual Wellness Visit Work for You

Your Annual Wellness Visit isn’t a routine physical—it’s designed to help create or update a personalized prevention plan.

During this visit, your provider will:

• Take a medical history

• Check vital signs and mental health status

• Review your current providers and prescriptions

• Identify future screenings and immunizations you need

Come prepared with questions and concerns. The more involved you are, the more value you extract from this benefit.

Why It Matters to Stay Enrolled

Some people question whether Part B is worth the premium—especially if they’re healthy. But skipping Part B unless you qualify for an exception can result in late penalties.

• If you miss your Initial Enrollment Period (IEP) and don’t qualify for a Special Enrollment Period (SEP), you may have to wait until the General Enrollment Period (January 1–March 31) to enroll—and coverage starts July 1.

• You’ll also face a 10% penalty for each 12-month period you were eligible but didn’t enroll.

In most cases, staying enrolled is cheaper in the long run, even if you rarely see a doctor.

Making the Most of What You Already Pay For

You’re paying for Part B every month, and if you don’t take full advantage of its benefits, you’re essentially leaving value on the table. From preventive screenings and mental health to DME and telehealth, this coverage supports your health in a wide variety of ways.

Review your usage every year and speak with a licensed agent listed on the website for help adjusting your coverage to suit your evolving healthcare needs.