Medicare Part B

Medicare Part B is the other half of Original Medicare. Part B is basically medical insurance. It provides insurance for outpatient medical care such as doctor visits, preventative services, ambulance services, mental health costs, and the cost of durable medical equipment. Under Part B insurance, in most cases you will pay 20% of the Medicare-approved amount for each item or service.

PART B COVERAGE

Medicare Part B in general covers, but it`s not limited to, next services and items:

  • Visits to doctor`s office
  • Durable medical equipment (wheelchairs, etc.)
  • Preventive services
  • Physical therapy
  • Flu shots
  • Chemotherapy
  • Pneumococal shots
  • Alcoholism counseling
  • Outpatient mental health care

On the other hand, there are some services that Part B does not cover, but Medicare Advantage plans do, including:

  • Routine hearing, dental and vision exams
  • Prescription drug coverage
  • Hearing aids or glasses
  • Long-term care
  • Emergency assistance while traveling outside U.S.
  • Long-term care
  • Fitness club membership (SilverSneakers membership)

MEDICARE PART B ELIGIBILITY

For Medicare Part B eligibility applies the same rules as for Medicare Part A. Primary criteria is that you must be age 65 or older and a U.S. citizen. Legal and permanent residents of the United States for at least 5 years in a row can also qualify for Part B. Finally, you can apply for it if ypu have been diagnosed with End-stage renal disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). Person under the age of 65 with certain disabilities that harden normal life and requires high care and attention can apply as well.

PART B ENROLLMENT

Person who is automatically enrolled in Medicare Part A is also automatically enrolled in Part B. However, because beneficiaries must pay a premium for Part B coverage, they have the option of turning it down. Those who choose to receive coverage through a Medicare Advantage plan – Part C must enroll in Part B.

There are 3 enrollment periods: Initial, General and Special enrollment period.

Initial enrollment period is for those who become eligible for part B but are not automatically enrolled in Medicare. The initial enrollment period is seven months long and begins three months before the month in which the individual first turns 65 and ends 3 months after the month of the birthday. Beneficiaries who do not file an application for Medicare benefits during their initial enrollment period could be subject to the Part B late-enrollment penalty.

General enrollment period is for the individuals who missed to sign during Inital enrollment period. The general enrollment period lasts for three months, beginning January 1 and ending with March 31 of each year, with coverage starting on July 1 of that year.

Special enrollment period may qualify you to enroll Medicare Part B if you were employed by a company that had more than 20 employees when you turned 65 years old and had health insurance through your job, union, or spouse.

MEDICARE PART B COSTS

Medicare Part B requires you to pay a monthly premium, given based on your adjusted gross income together with a yearly deductible before coverage begins. You are also responsible for paying part of the costs that Part B does not cover. So your costs if you enroll in part B will include Medicare Part B monthly premium, coinsurance (part od the cost that Medicare does not pay) and yearly deductible.
The standard monthly fee for Part B is $170.10 in 2022. It is higher for recipients who have higher incomes. The annual deductible for Part B is $233 in 2022. In addition, the patient pays 20% of the bill as a coinsurance payment.

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