If you have held insurance coverage in the past through your employer, understanding the different parts of your coverage may be a new experience. The different parts of Medicare help its recipients determine the different types of coverage offered and how those benefits apply to their healthcare costs.
Let’s look at the second part of Original Medicare, Medicare Part B: Medical Insurance.
WHAT IS MEDICARE PART B?
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Medicare Part B is the second part of “Original Medicare”. While Medicare Part A helps cover costs for inpatient hospital stays, hospice care, and more, Medicare Part B helps pay for the care you receive as an outpatient at places like the doctor’s office or medical clinic. Part B helps provide coverage for the medical services and supplies that are necessary for the prevention and treatment of health conditions
MEDICARE PART B ELIGIBILITY
Though Part A and Part B provide different types of coverage, most people who are eligible for Medicare Part A are also eligible for enrollment in Medicare Part B. While many people may be entitled to free Medicare Part A, Medicare Part B (health insurance) does require a monthly premium.
Because Medicare Parts A & B were designed to work together, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty for as long as you have Part B.
So, be sure to enroll when you first become eligible.
WHAT DOES MEDICARE PART B COVER?
Generally, Part B helps cover doctor visits and outpatient care. Let’s look at some of the things you can expect coverage for with Medicare Part B:
- Doctor office visits
- Preventive services, such as certain tests and
- screenings
- Durable medical equipment (DME)
- Canes
- Crutches
- Wheelchairs
- Hospital beds
- Kidney machines
- Oxygen
Medicare Part B shares some costs of care if you need to be hospitalized. However, as a patient, you may still have out-of-pocket costs for the received care. Medicare Part B beneficiaries can expect to pay the copays, deductible, or coinsurance cost-sharing for the medical services they receive.
WHAT DOES PART B COVERAGE LOOK LIKE?
Now that we know some of the things covered by Part B let’s examine how coverage may apply. Medicare Part B helps provide coverage for medical services rendered to you at places like a doctor’s office, or an outpatient surgical center. Here are some common services covered under Medicare Part B:
- X-rays, MRIs, CT Scans
- Physical Therapy
- Chemotherapy
- Preventive services, such as certain tests and screenings
- Emergency room visits and care
WHAT ISN’T COVERED?
While Part B does help supplement the coverage gaps provided by Part A, like any healthcare policy, there are limits to the coverage provided by Medicare Part B. Expenses Part B does not cover are:
- Annual eye exams and glasses
- Dental work
- Long term care facility
- Traditional pharmacy benefits/coverage
MEDICARE PART B PREMIUMS AND COSTS
While Medicare Part A provides free or low-cost coverage for its beneficiaries (you), Medicare Part B does come with additional costs.
Many people choose to delay their enrollment in Medicare Part B if they are still working and have coverage through their employer. Some may also choose to delay their enrollment if they are still covered under their spouses’ policy.
ADDITIONAL COSTS AND CONSIDERATIONS
Medicare Part B premiums are set by the federal government. While these premiums are standard for the year, your rate may change from year to year. If you are collecting Social Security, the monthly premium will be deducted from your monthly social security benefit.
The federal government sets the Part B monthly premium. The standard premium amount for Medicare Part B is $144.60 in 2020. However, If your income is above $87,000 you might pay a higher Part B premium. Income is determined based on your income tax returns from two years prior to enrolling.
You’ll also be subject to an annual deductible. The deductible for 2020 has been set at $198. After your deductible has been met you’ll have to pay 20 percent of the cost for doctor visits and other outpatient services.
Explore Your Options
Medicare Parts A and B work together to provide you with basic healthcare coverage after turning 65. However, there are common healthcare costs that Original Medicare does not cover. Medicare Advantage Policies work to provide you with more comprehensive coverage that meets your healthcare needs.