What is Medicare Part B?
Medicare Part B, also known as Medical Insurance, helps cover medically necessary doctors’ services, outpatient care, home health services, durable medical equipment, and other medical services.
Part B also covers many preventive services. Medicare Part B has a premium associated with it. Here is a handy reference sheet showing the costs that go along with Medicare and the premium for this year.
Because of the premium associated with Part B, if you have other insurance options presented to you, possibly as a previous work benefit, you should seek qualified assistance to determine if it is in your best interests to keep Medicare Part B or put it off in lieu of your other retirement benefits.
Medicare Part B payments are very easy to understand, and typically follow what you are used to seeing with major medical insurance. Part B typically starts with a small, annual deductible. If the Part B deductible applies, you must pay all costs up to the Medicare-approved amount, until you meet the deductible before Medicare begins to pay its share. Then, after your deductible is met, you typically pay 20% of the Medicare-approved amount of the service. There’s no yearly limit for what you pay out-of-pocket. You pay nothing for most covered preventive services if you get the services from a doctor or other qualified health care provider who accepts assignment. However, for some preventive services, you may have to pay a deductible, coinsurance, or both. These costs may also apply if you get a preventive service in the same visit as a non-preventive service.
Medicare Part B services include most medically-necessary services as well as rehabilitative therapy, some chiropractic services, many diabetic supplies, durable medical equipment, and a very limited amount of prescription drugs. Most prescription drugs are covered under the separate part of Medicare known as Part D.
As important as it is to be aware of what Medicare Part B covers, it is also important to know what it does NOT cover.
Here is a brief list of what isn’t covered by Medicare Part B:
- Most dental care.
- Eye examinations related to prescribing glasses.
- Cosmetic surgery.
- Hearing aids and exams for fitting them.
- Long-term care.
Limitations, copayments, and restrictions may apply.
Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.