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Medicare Part B

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Medicare Part B is the medical portion of Original Medicare. This includes coverage for outpatient services while visiting your doctor.

What Does Medicare Part B Cover

Medicare Part B Coverage Part B provides coverage for a mixture of outpatient medical services. This includes coverage for preventative vaccines, cancer screenings, annual lab work, and much more.

It will cover preventative services in addition to specialist services. Part B even covers services for mental healthcare, durable medical equipment that your doctor finds medically necessary, or an ambulance ride.

Also, Medicare Part B will cover services that you receive while in the hospital. This includes surgeries, diagnostic imaging, chemotherapy, and dialysis if you obtain drugs while at the hospital, it will also provide coverage for those.

Part B Coverage Summary

What Does Medicare Part B Not Cover

Part B does not provide dental or vision benefits. It also doesn’t cover routine foot care of cosmetic surgery. Additionally, it won’t cover custodial care, such as help with bathing, dressing, or the cost of an assisted living facility.

How Much Does Medicare Part B Cost

The out of pocket costs for Part B includes a premium, deductible, and coinsurance. Medicare Part B will cover 80% of your medical expenses once you’ve met the annual deductible. If you have a Medigap plan, the yearly deductible and coinsurance could have coverage.

You must pay the monthly premium for Part B. Most beneficiaries will pay the standard monthly premium. Those in a higher income bracket will pay more. We’ll cover more on that below.

What’s the Part B Premium

The Part B premium is $144.60 a month. If you receive Social Security, Railroad Retirement Board, or Office of Personnel Management benefit payments, your Part B premium will be deducted from your monthly check.

If you don’t receive Social Security, you could get a monthly bill from Medicare. They have online payment options for those with a MyMedicare account.

What’s the Part B Deductible

Part B has an annual deductible of $198. This deductible can slightly increase each year.

What’s the Cost for Part B for Higher-Income Earners

Most people pay the standard premium amount. However, those with a gross income above a certain amount may pay an Income Related Monthly Adjustment Amount.
Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS. If you have a change in circumstance, you can appeal to your IRMAA.

2020 Medicare Part B Premiums

How to Sign Up for Medicare Part B

Beneficiaries collecting Social Security benefits when they age into Medicare at 65 will automatically be enrolled. You’ll receive your Medicare card the month before your birthday. If you’re not collecting Social Security benefits, you’ll need to enroll yourself. You can find out how to enroll online, over the phone, or in-person here.

All beneficiaries will have an Initial Enrollment Period window for Part B enrollment. This period begins three months before the month you turn 65th birthday and ends three months after. If you don’t enroll during your Initial Enrollment Period and don’t have creditable coverage, you could be subject to a penalty.

What’s the penalty for refusing Medicare Part B

Medicare Part B Late Enrollment Penalty In most cases, if you do not sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B. Your monthly premium will go up 10% for each full 12-month period you go without coverage.

You won’t pay the penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period. An example would be if you continued working past 65 and had creditable coverage through an employer group health insurance.

FAQs

Does Medicare Part B cover prescriptions?
Part B will cover prescriptions administered in a hospital or by a healthcare professional. For example, if you need chemotherapy, Part B would cover it. It does not usually cover prescription medications administered at home. However, any medications not covered under your Part B may be covered under Part D.
How long does it take to get Part B after applying
If you’re automatically enrolled in Part B, your coverage begins the first day of the month you turn 65. The only exception is if your birthday is on the first day of the month. It can take up to 30-60 days to be approved if you’re applying outside your initial enrollment period and not automatically enrolled.
Am I required to pay the Part B deductible upfront
No, we always tell our clients to never pay the Part B deductible upfront. Your doctor will need to bill Medicare first. They will then bill you for the $198 deductible. When you pay this upfront, Medicare has no record of it, and you’re still expected to meet the deductible. Often, doctors’ offices don’t understand how Medicare billing works and ask that you pay some sort of copay upfront.
Can I get Medicare Part B for free?
Beneficaries with low incomes may qualify for help that pays your monthly premium for Part B. These programs have their income and eligibility limits.
Can I sign up for Medicare Part B online?
Yes, you can sign up for Part B online at www.socialsecurity.gov.
Do you pay the Part B premium with Medicare Advantage?
Yes, you still must pay the monthly premium for Part B when you enroll in a Medicare Advantage plan.
Do I need Medicare Part B if I have other insurance?
Depending on the insurance you have, you might be able to delay Medicare Part B. For example, if you have FEHB benefits or large employer group coverage, you may not need Part B.

Get Help with Your Part B Benefits

We can help you avoid paying medical costs that Part A and Part B won’t cover. Our agents have helped people just like you find a supplement plan that fits their healthcare needs. Contact us for a free quote or fill out our online rate form now to get started!

2 Comments

  1. I’m on a cpap for sleep,apnea at night. My pulmonary Dr did a home oximetry test at my home and Virtux came back and said “per the public health emergency dated 3.1.2020 with CMS waiver 1135, it appears I qualify for nocturnal oxygen per Medicare guidelines and to contact Lincare, the respiratory company, for coverage guidelines I. Lincare says I have to go to a,sleep clinic. I can’t believe with vivid 19 that would be required. Lincare called Medicare and they said they would,only cover oxygen for 2 months and then I would still be required to,go,for,a,sleep study. My recent lab work and pulse oximetry show I need oxygen only at night. Please advise.

    • Hi Cheryl! More than likely, there won’t be a way around the sleep clinic study. Medicare does cover a limited amount of oxygen therapy, but there are alternatives you can use that Medicare will cover. We have a great article on both oxygen therapy coverage and CPAP coverage that may help you learn more.

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