There are a few different parts to Medicare that provide coverage for different medical procedures and practices. Having the right Medicare coverage can ensure that you get the proper care that you deserve. That is why it is vital to understand the different parts of Medicare and what they cover. Today we will be diving into Medicare Part B to explain what it is, who is eligible, how to enroll and how much it costs.
What is included in Medicare Part B?
Medicare Part B covers a variety of different kinds of services. We’ll divide them into two categories: medically necessary services and preventative services. Medically necessary services include procedures or materials necessary to treat a certain medical condition. This can include ambulance service, emergency care or even proper medical equipment. Preventative services are ones that help to prevent illnesses or detect them at early stages. Things like flu shots, diabetes screenings and cardiovascular screenings are all considered preventative services that are covered by Medicare Part B. Medicare Part B also covers clinical research, some prescription drugs and both inpatient and outpatient mental health care.
Medicare Part B is traditionally a part of Original Medicare, However, if you are on a Medicare Advantage Plan, then you receive both Medicare Part A and Part B through a private insurance plan. Medicare Advantage plans, also known as Medicare Part C, must provide at least the same amount of coverage as an Original Medicare plan. In fact, they often provide more coverage for certain benefits like dental, hearing and vision care. If any of these added features are important to you, consider enrolling in a Medicare Advantage Plan. Learn more about Medicare Advantage Plans here. Keep in mind that having a Medicare Advantage Plan will include all of the features of Medicare Part B plus some added benefits, so Medicare Part B coverage is generally the same across the board.
In order to find out what your Medicare Part B covers, talk to your doctor or healthcare provider. There may be certain services or resources that are important for you to have covered. Always find out exactly what can be covered by your Medicare plan to ensure that it is the best plan for you.
Am I eligible for Medicare Part B?
There are some eligibility requirements for Medicare Part B. If you are eligible for premium-free Medicare Part A, then you are automatically eligible for Medicare Part B. If you are not eligible for premium-free Medicare Part A, then you still may be eligible for Medicare Part B if you meet certain criteria. As long as you are 65 years old or older and are a U.S. citizen or a permanent resident of the U.S. for at least five years, you are considered eligible for Medicare Part B.
There are some other ways in which you may qualify for Medicare Part B coverage. You may also be eligible for Part B if you are under 65 and receive Social Security or Railroad Retirement Board disability aid. If you meet these requirements, then you will automatically be enrolled in Medicare Part A and Part B after two years of disability benefits. Furthermore, if you have end-stage renal disease or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), then you can be eligible for Medicare Part B enrollment. Be sure to check with your doctor or healthcare provider to find out if you qualify for Medicare Part B.
When do I enroll in Medicare Part B?
Traditionally, you will enroll in both Medicare Part A and Part B during your Initial Enrollment Period or a Special Enrollment Period if you qualify for one. If you miss out on enrolling during either of these timeframes, then you can always enroll during the General Enrollment Period, which lasts from January 1 to March 31 every year. Be aware that you may be charged a late penalty if you do not enroll in Medicare Part B during the correct time frame. There are lots of different Medicare enrollment periods and it can be difficult to understand exactly when to enroll. In order to figure out when you are eligible to enroll, learn about the different Medicare enrollment periods here.
You may be automatically enrolled in both Medicare Part A and Medicare Part B if you are under 65 years old and receive retirement benefits due to a disability. If you are not automatically enrolled, then check with Social Security to see about enrolling. You can visit their website, give them a call, or visit their offices to ask about Medicare enrollment for persons with disabilities.
How much does Medicare Part B cost?
Medicare rates are important to keep in mind as you begin to enroll in Medicare. In 2020, the standard monthly premium for Part B is $144.60. For most, this cost is automatically taken from their monthly Social Security benefit. Of course, this amount can fluctuate based on your income, medical needs and location. It can also depend on if you are married or not. Keep in mind that premiums for Medicare Part B are likely to change year to year and person to person.
Along with premiums, there are deductibles and coinsurance costs that you will have to pay. These prices can range. For reference, annual deductibles averaged $198 in 2020. In general, there is a 20% coinsurance for many different services. Coinsurance rates are applied if your doctor accepts assignment for a service that is covered by Medicare Part B. Because your doctor accepts assignment, they agree to not charge you more than the amount that Medicare approves. Medicare is designed to help you save money on healthcare costs, so don’t let these numbers scare you.
Being aware of costs, coverage and eligibility is a necessity as you begin to think about Medicare. There are a lot of different moving parts to Medicare, so understanding each one can ensure that you receive the best coverage options. If you are ever unsure of your eligibility or coverage needs, be sure to speak to a doctor or a Medicare professional.