Medicare Part B is the medical portion of Original Medicare. This includes coverage for services provided by your doctors that are preventive and medically necessary.
What Does Medicare Part B Cover?
Part B provides coverage for a mixture of outpatient medical services. This includes coverage for preventive vaccines, cancer screenings, annual lab work, and much more.
It will cover preventive services in addition to specialist services. Part B even covers services for mental healthcare, durable medical equipment that your doctor finds medically necessary.
Also, Part B will cover some services 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.
Listen to this Podcast Episode Now!What Does Medicare Part B Not Cover?
Part B does not provide dental or vision benefits. It also doesn’t cover anything not considered medically necessary or preventive. Additionally, it won’t cover prescriptions taken at home or long-term care.
How Much Does Medicare Part B Cost?
The out-of-pocket costs for Part B include a premium, deductible, and coinsurance. Part B will cover 80% of your medical expenses once you’ve met the annual deductible. 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.
In 2021, the Part B premium is $148.50 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. Part B has an annual deductible of $203. This deductible can slightly increase each year.
If you don’t receive Social Security, you could get a monthly bill from Medicare. They have an online payment option called Easy Pay for those with a MyMedicare account.
Does Medicare Part B cover 100 Percent?
Part B covers 80% of your medical costs and also comes with an annual deductible and monthly premium.
Does Medicare Part B Have a Copay?
No, Medicare Part B does not come with copays.
Who Qualifies for Free Medicare Part B?
If you’re a lower-income beneficiary and are dual-eligible for both Medicare & Medicaid, you may be eligible for a Medicare Savings Program that will pay all or most of your Part B premium.
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 apply online, over the phone, or in-person.
All beneficiaries will have an Initial Enrollment Period for both Part A & Part B. 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.
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.
How to Reinstate Medicare Part B
Go to MyMedicare.gov website and log into your account. Complete the application and include all the required documents. You can track the status in your dashboard.
FAQs
How to Get Help with Medicare Part B
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I will be 65 in September and recently applied for Medicare, however I was just informed that since I will begin drawing my deceased spouse’s Social security first delaying mine until age 70, that I should file for Medicare under her record so the premium payment comes out of my spousal benefit. How do I correct this error?
Hi Brenda! You will want to contact Social Security or Medicare directly to update your account accordingly. You will need to pay your Part B premium through your MyMedicare dashboard until this is updated to avoid a lapse in coverage.
What if you don’t live in the USA?
Hi Nick! If you have another form of international health coverage, it may be creditable coverage. There is very limited documentation on what international health insurance is considered creditable under Medicare. You would need to contact Medicare directly to make sure. If you don’t have any coverage, you will be penalized for not enrolling when you were first eligible, even if you are not living in the USA.
Hi, I submitted my online application for Part B medicare (I have part A for a while now) and they received it 6/20/21. I have not received my new medicare card in the mail for A & B as of yet. If I have to see a doctor (currently having some pain) what can I do at this point?
Hi Kathy! Have you created an account in MyMedicare.gov? You may be able to see your Medicare number in your dashboard to provide your doctor with.
Hello, if I have only Medicare Part B. Will my outpatient doctor/Clinics visit covered outside my resident State?
Hi Markeya! Yes, Part B will travel with you nationwide. You will have 80% coverage for any outpatient medical costs.
Hello. As a retired Federal employee, I have FEHBP coverage with UHC-MD/IPA., an HMO. I didn’t sign up for Medicare when I became eligible in 2011. The part B premium will cost 148.50 plus a substantial late filing penalty when it kicks in July 2021 as I only signed up for Medicare last summer. Would I be better off dropping Part B? I don’t want to pay more that I have for Part B type services covered by the HMO. Many thanks for your advice.
Hi Larry! Most FEHB plans offer a “coordination of benefits” with Medicare. The coordination cut costs by waiving deductibles, copayments, and coinsurances. Your penalty will continue to increase, the longer you wait to enroll the more your premium will be if you do enroll in the future. So, yes you can drop Part B, but that may not be the best choice in the long run since we cannot predict our healthcare costs. We have more on FEHB and Medicare benefits here.
If you are being billed for part B and are now ready to sign up for SSI will they
start taking it out of your SSI or do they still bill you.
Hi Deborah! Once you draw SSI, you should see the Part B deductible start to automatically come out of your check.
What form does an out of network provider fill out in order for patient to receive reimbursement
Hi Norman! If you have a Medicare Advantage plan I would contact your carrier directly to get the correct forms necessary. Normally, you’re responsible for 100% of the cost if the provider is out of network.
How do I submit to Medicare for my provider accepting only at the time of the appointment and does not bill insurance?
Hi Barbara! You will need to complete the Patient Request for Medical Payment Form (CMS-1490S) and submit it to Medicare through your MyMedicare account. It must be complete no more than 12 months after services were received.