What is Medicare Part B?

As part of Original Medicare, Medicare Part B covers many of the things that are necessary to treat your condition. Coverage is extensive and spans preventative and curative treatments, both of which we will address in this guide to Medicare Part B.

What Does Medicare Part B Cover?

Most of the services covered by Medicare Part B are curative in nature, which means they are designed to treat a condition. However, it can also cover some preventative measures. 

Generally, the coverage spans many of the things that are deemed to be medically necessary, including, but not limited to, the following:

  • Ambulance Services: Including any necessary services provided inside the vehicle
  • Assisting Services: Language support, smoking cessation, and educational services designed to help the patient manage their condition
  • Blood Tests: Included when tests have been ordered by a physician and used to screen and diagnose
  • Chiropractic Services: The extent to which these services are covered is very limited and will depend on the purpose, patient, and ordering physician
  • Diabetes: Including screenings, management services, and many other essential supplies and services
  • Ear and Eye Care: Includes glaucoma tests, vision tests, hearing tests, and, in some cases, eyeglasses
  • Flu Shots: Especially important for seniors and those in high-risk professions and with preexisting medical conditions
  • Mental Health Care: Covered when provided as an outpatient service.
  • Medications: Some prescription medications are covered, including immunosuppressants prescribed following a transplant
  • Other Shots: Includes hepatitis B and other medically necessary vaccinations
  • Tests and Screenings: A multitude of screenings and tests are covered when these are ordered by a healthcare professional and used to diagnose. Includes EKGs, prostate cancer screenings, pap tests, and mammograms

Who is Eligible for Medicare Part B?

If you are eligible for premium-free Medicare Part A, you are also eligible for Medicare Part B and can enroll by paying a small monthly premium. Anyone who is not eligible for free Medicare Part A can qualify if they are at least 65 years old and have lived legally in the United States for at least 5 consecutive years.

As with Medicare Part A, qualification is also possible for anyone diagnosed with ALS or ESRD and anyone receiving disability benefits.

When and How to Enroll in Medicare Part B

Anyone receiving retirement benefits before they turn 65, and anyone who qualifies for Medicare as a result of a disability, will automatically be enrolled in both Part A and Part B as soon as they become eligible.

Everyone can enroll during the General Enrollment Period, which runs from the 1st of January to the 31st of March every year. A late penalty fee will be charged to anyone who does not enroll when they first become eligible.

Premiums for Medicare Part B

Medicare Part B premiums typically vary from year to year and the amount can also change depending on the applicant’s personal circumstances. In 2020, the premium was $144.60. In most cases, this will be deducted from your Social Security benefits. 

Higher-income individuals will be charged a higher premium. In 2020, for instance, the aforementioned $144.60 was paid only by those filing with $87,000 or less every year ($174,000 for those filing jointly).

Anyone earning between $87,001 and $109,000 as a single filer will pay $202.40, and this increases to a maximum of $491.60 for individuals earning half a million dollars or more every year.

Deductibles and Coinsurance

Along with the premiums, you also have to pay a deductible, and this is charged for all covered services. In 2020, the deductible was just $198, but an additional 20% coinsurance is required for most covered services. This means you will pay 20% of the cost, along with a fixed fee of $198, every time a covered service is accepted.

More Information on Medicare Part B

To get more information on Medicare Part B, visit the official Medicare website. It contains information on applying for all aspects of Medicare, as well as a rundown of the latest costs and the extent of coverage provided.