Medicare Part B Insurance
What is Medicare Part B coverage?
Medicare Part B (medical insurance) helps cover medically necessary services and supplies needed for the diagnosis or treatment of your health condition. This includes outpatient services received at a hospital, doctor’s office, clinic, or other health facilities. Medicare Part B also helps cover many preventive services to prevent illness or detect them at an early stage. Together, Medicare Parts A and B are known as Original Medicare.
Medicare Part B Insurance Benefits
Medical services and supplies covered by Medicare Part B include (but may not be limited to):
- Doctor visits
- Laboratory tests and X-rays
- Emergency ambulance services
- Mental health services
- Durable medical equipment
- Preventive services, such as pap tests, flu shots, and screenings
- Rehabilitative services, including physical therapy, occupational therapy, and speech-language pathology services
Medicare Part B Insurance costs
You will pay both a monthly premium and a yearly deductible for Medicare Part B. The monthly premium amount may vary depending on your specific situation:
If any of the following applies to you, you will generally pay $148.50 for your Part B premium in 2021:
- You are not receiving Social Security or Railroad Retirement Board benefits.
- You are billed directly for your Part B premium.
- You have both Medicare and Medicaid coverage, and Medicaid pays for your monthly premiums.
You may have to pay a higher premium if your yearly income is above a certain amount, as reported on your tax return from two years ago. Please see the chart below:
|If your yearly income in 2018 (for what you pay in 2020) was||You pay each month (in 2021)|
|File individual tax return||File joint tax return||File married & separate tax return|
|$88,000 or less||$176,000 or less||$88,000 or less||$148.50|
|above $88,000 up to $111,000||above $176,000 up to $222,000||Not applicable||$207.90|
|above $111,000 up to $138,000||above $222,000 up to $276,000||Not applicable||$297.00|
|above $138,000 up to $165,000||above $276,000 up to $330,000||Not applicable||$386.10|
|above $165,000 and less than $500,000||above $330,000 and less than $750,000||above $88,000 and less than $412,000||$475.20|
|$500,000 or above||$750,000 and above||$412,000 and above||$504.90|
If you did not enroll in Medicare Part B when you were first eligible, you might have to pay a late-enrollment penalty in the form of a higher premium, unless you are eligible for a Special Enrollment Period. In addition to your monthly premium, you will pay $203 in 2021 for the yearly Part B deductible.
For individual services and supplies, your Medicare Part B costs may vary. Some preventive services are completely covered if your provider accepts Medicare assignment. If the Medicare Part B deductible applies, you must pay all costs until you meet the yearly deductible amount, before Medicare begins paying its share.
After your deductible is met, you typically pay 20% of the Medicare-approved amount for the services rendered. You may also owe a copayment for outpatient services. For example:
- You may pay a copayment if you receive blood as part of your treatment. Even if the blood was donated free of charge to a blood bank, you may have to pay a handling or processing fee.
- If you receive cardiac rehabilitation services as a hospital outpatient, you generally pay a co-insurance. The Medicare Part B deductible applies.
- If you get chemotherapy as a hospital outpatient, you will generally be charged a co-insurance. The Part B deductible may apply.
Did you know that some Medicare Advantage plans and Medicare Supplement plans might offer additional services beyond Medicare Part B? For example, some Medicare Advantage plans include benefits like wellness programs and routine vision and dental benefits. Medicare Parts A and B do not typically cover these supplementary benefits. Contact us today to learn more about Medicare Part B!