Medicare Part B
Medicare Part B is one of the 3 parts of Original Medicare. Part B is your health insurance and it provides coverage for preventative care or medically necessary outpatient medical services.
A medically necessary service is a service or supply that is needed to treat or provide a diagnosis for a medical condition. Preventative service is a service that’s conducted in order to prevent an illness or detect it.
What Will Medicare Part B Cover?
Your Medicare Part B will provide medical coverage for a variety of medical services. Here are some of the most common outpatient services covered under Part B:
- Doctor Visits
- Preventative Care (Flu Shots, Mammograms, Colonoscopies, etc.)
- Ambulance Rides
- Chemotherapy & Dialysis
- Some surgeries
- Clinical research
- Durable medical equipment (DME)
- Lab Testing
- Some Chiropractic care
- Medications given in a medical setting (Antigens, Insulin with an insulin pump, Osteoporosis injections, and infused medications)
Medicare Part B Benefits
The following is a breakdown of your Medicare Part B benefits. It shows you what Medicare pays. You are responsible for the remaining costs unless you have a Medicare Supplement plan to cover these expenses.
Part B Benefits
Services | Medicare Pays |
|---|---|
First 3 pints | $0 |
Next $198 of approved amounts | $0 |
Remainder of approved amounts | Generally 80% |
Services | Medicare Pays |
|---|---|
First $198 of approved amounts | $0 |
Remainder of approved amounts | Generally 80% |
Part B Excess Charge | $0 |
Services | Medicare Pays |
|---|---|
Tests for diagnostic services | 100% |
Services | Medicare Pays |
|---|---|
First $250 during 1st 60 days | $0 |
Remainder of charges up to a a lifetime max of $50,000 | $0 |
How Much Will Medicare Part B Cost?
Medicare Part B has a monthly premium as well as an annual deductible. The cost of the premium and deductible can change every year. Most people end up paying the monthly amount that is made by the United States government. A smaller amount of people can owe more based on their income level.
How you’ll Pay For Your Part B
Here are the 4 ways to pay for your Part B premiums:
- Automatically: If you’re already enrolled and receive Social Security benefits, your Part B premiums will be deducted by Medicare straight from your SS check.
- Quarterly: If Medicare doesn’t deduct your Part B premium, then they will send you a quarterly bill.
- Credit Card: You also have the ability to pay by credit card if you pay quarterly. This option can be found at the bottom of your quarterly invoice. You will simply fill out the payment coupon in the invoice. Once that’s completed, you’ll mail it to the Medicare Premium Collection Center.
- Medicare Easy Pay: The last payment option is called the Medicare Easy Pay. This deducts your Part B premium payments every month from your preferred savings or checking account. The Medicare Easy Pay option is a free service.
Medicare Eligibility
Medicare Part B eligibility is linked to your Medicare Part A. If you are eligible for premium-free Medicare Part A; then you are eligible for Medicare Part B. You can simply enroll and pay your monthly premium.
However, if you aren’t eligible for premium-free Medicare Part A, then you may qualify for Part B if you meet these requirements:
- You are age 65 years or older
- You are under the age of 65 years old and have a disability
- You are a United States citizen or a permanent resident who resides in the U.S lawfully for at least 5 consecutive years
Enrollment
Are you getting your retirement benefits before age 65? Do you qualify for Medicare due to a disability? If you answered yes to these questions you will usually be enrolled automatically into both Medicare Part A and Part B once you become eligible.
Here are your Medicare enrollment periods:
- Initial Enrollment Period (IEP) is a 7 month period that starts 3 months before 65th birthday “month”; your birthday month; and finally the 3 months after your birthday month. You may enroll in Medicare Part A and Part B during your IEP.
- Special Enrollment Period (SEP) is a special time that allows some people to delay enrollment in Part B without incurring a late enrollment penalty. You have to get confirmation of creditable coverage from your employer.
- General Enrollment Period (GEP) Each year a General Enrollment Period for Medicare happens between January 1st and March 31. This is the time (usually the only time) when people who are eligible for Medicare Part A and/or Part B – but failed to enroll when 1st eligible. This is their other opportunity to join. Be aware, your coverage won’t start until July 1 of that that year. You still may have to pay a late enrollment penalty because you didn’t sign up when you were 1st eligible.
What if I’m late enrolling?
Make sure you don’t procrastinate with your Medicare enrollment – it can cost you! If you’re late with your Medicare Part B enrollment, you may have to pay a penalty for life. It’s fairly common to miss your Medicare enrollment period so let’s avoid that at all costs.
Keep in mind that once you turn 65 years old (or older) and have Medicare Part B, you will enter your six-month Medicare Supplement Enrollment Period.
Get Medicare Enrollment Period Help
We totally understand that all of this can get really complicated. There’s even a published book titled, Medicare for Dummies because it can get so overwhelming. The importance of understanding all of your Medicare options, rules and enrollment periods is paramount.
We hope that this article has helped, but we totally understand if you need some extra help. We know that missing an important enrollment date can cost you money that you’ll end up paying for the rest of your life.
If you want to be confident that you aren’t missing any deadlines then contact REMEDIGAP today! We’re Medicare experts and will help you with enrollment so you can avoid any costly enrollment penalties.
