Medicare Part B in Virginia

Medicare Part B in Virginia is supplemental to the Medicare Part A coverage option. Medicare Part B is commonly referred to as medical insurance while Part A is called hospital insurance, although Part B can cover some services received in hospitals or other medical facilities.

Part B Medicare coverage is the type most commonly used as it covers routine doctor visits, wellness checks, urgent care visits and more. Medicare Part B provides preventive screenings, outpatient care and the cost of medical supplies, such as walkers or wheelchairs. Get information on Medicare Part B cost distribution, how to get Medicare Plan B and more information about what the plan covers. For an in-depth guide on Medicare Part B coverage, click here.

How to Get Medicare Medical Insurance

All who apply for Medicare Part B plans must meet basic Medicare eligibility requirements, which are set according to age and health standards. Applicants for Medicare Part B must also be legal residents of the United States. This means that you have been a U.S. citizen or permanent legal resident for a certain number of years. Medicare Plan B and other Medicare applications can only be filed if, in addition to the legal presence requirement, one of the following statements is true:

  • You are 65 years old, or older
  • You under 65, but have received disability benefits from the Social Security Administration (SSA) or Railroad Retirement Board (RRB) for 24 months
  • You are any age and suffer from Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig’s Disease) or End-Stage Renal Disease (ESRD, or permanent kidney failure that requires dialysis or a kidney transplant)

How to Enroll in Part B Medicare in Virginia

Medicare Part B enrollment for medical insurance coverage is an optional part of initial enrollment in Medicare. Many view Medicare Part B as optional because it usually requires a monthly premium payment, and because the Part A coverage option alone is sufficient for meeting the law’s requirement to have health insurance. However, it may not be wise to opt out of Medicare Part B coverage, depending on your health needs Not enrolling in Medicare Part B during your initial enrollment period (IEP) can result in paying late enrollment penalties that can extend for a long period of time. Your IEP is a seven-month-long window of opportunity that begins three months before your 65th birthday, includes your birth month, then continues for three more months after your birth month. Automatic enrollment in Medicare Part B can happen if you have been receiving retirement or disability benefits from the SSA or RRB. If you have ALS, Medicare Part B and Medicare Part A will automatically begin the same month that you start to receive Social Security disability benefits. If you should get automatic Medicare Part B enrollment but fail to receive your card, you should let the SSA or RRB know about the delay.

Medicare Plan B enrollment is available online through the Social Security Administration (SSA). If you prefer to apply for Medicare Plan B in person, contact your local SSA office and request a Medicare application appointment. You can also apply for Medicare Plan B and other Medicare programs over the phone by calling the SSA and asking to speak to a representative familiar with Medicare enrollment. You can also apply for additional Medicare assistance through Virginia’s CommonHelp program. Download our comprehensive guide to get more information about obtaining all Parts of Medicare coverage.

If you fail to get Medicare Part B during your IEP, you can enroll during a Special Enrollment Period (SEP) that will open at a specific time of year. There are also SEP options for those who have employer-based health insurance coverage at the time they qualify for Medicare coverage.

Costs of Medicare Part B in Virginia

Medicare Part B costs in Virginia are paid through premiums, deductibles and copayments. You will pay a Medicare Part B premium unless you fall into a low enough income bracket that you qualify for Medicare assistance through the Commonwealth of Virginia. Plan B Medicare applicants with higher than average incomes will have an additional amount added to their monthly premiums. Your Medicare Part B program will provide a handbook and website with annual updates to coverage and cost information for Medicare options.

Medicare Part B premiums are a fee you pay to receive coverage each month. The Plan B Medicare premium amount is set by Medicare law and will vary according to your current income. Your Medicare Part B cost includes a flat-rate annual deductible that you must meet before Medicare begins paying for services. The last part of Medicare Part B cost is the copayment, or copay. Many Medicare Part B services are free from co-payments, while others require participants to pay a certain percentage of the service or procedure cost. Medicare Plan B participants have the option of paying these percentages out-of-pocket or by using a secondary form of health insurance that works along with Medicare.

Medicare Part B Covered Services

Medicare Part B covers a wide variety of services that can benefit recipients. Medicare Part B plans include services in the following categories and many more:

  • Preventive health care: Medicare Plan B includes screenings for diabetes, cardiovascular disease and other common ailments.
  • Cancer screenings: Breast, colorectal and prostate cancers are among those routinely screened for.
  • Mental health: Mental health services include depression and anxiety treatment and counseling.
  • Testing: Medicare Part B covers X-rays, MRIs and other diagnostic testing.
  • Wellness: Annual wellness visits are included with your Medicare Part B costs.

Recipients of Medicare Part B should make sure to learn about Medicare coverage options to see which plans are right for them and their eligible family members.

Virginia Department of Social Services