Important Things You Need To Know About Medicare Part B
Medicare is a health coverage program run by the government for elderly individuals who are 65 years and older. Some younger people with disabilities and conditions like end-stage renal disease (which leads to permanent kidney failure that requires dialysis or transplant) are also covered under Medicare. It is divided into four parts:
- Medicare Part A – This section covers hospital insurance, i.e., inpatient hospital stays, care in the nursing or assisted-living facilities, hospice care and some forms of medical care at home.
- Medicare Part B – The Part B encompasses expenditures for doctor’s fees, outpatient assistance, medical supplies and preventive services.
- Medicare Part C – Also referred as Medicare Advantages Plans, Part C is offered by private health insurance providers (which are approved by Medicare) to offer services that aren’t covered in Part A (Original Medicare) and Part B.
- Medicare Part D – This section covers prescription drugs for the Original Medicare plan. Like Advantage Plans, Part D is also provided by private health insurance companies that are authorized by Medicare.
Medicare Part B
The following article will specifically talk about all the services and benefits that are managed by Medicare Part B.
As mentioned earlier, Medicare Part B is a part of the Original Medicare program which comprises medical services and supplies that are essential for your treatment. This covers preventive services, outpatient care, ambulance assistance and durable health equipment. It even includes intermittent or part-time health and rehabilitative services at home. For instance, it covers physical therapy if it is instrumental to your recovery.
The preventive services that come under the Medicare Part B are a one-time physical exam, flu and hepatitis B immunizations, screenings for conditions like diabetes, cancer, cardiovascular diseases, STDs, glaucoma, HIV, depression, hepatitis C, obesity and more. It even pays for counseling expenses associated with alcohol abuse, sexual diseases, and obesity. Furthermore, it also includes costs for an annual wellness visit.
However, before you enroll for Medicare Part B, ensure that you peruse through all its terms and conditions. This is because there might be some exceptions to certain services. For example, Medicare Part B will only cover ambulance expenses, if any other form of transportation proves to be unaccommodating to your condition. So, if you use an ambulance during a serious condition like cardiac arrest, Medicare will cover it.
Similarly, you should also be well-aware of all the medical services that Medicare Part B doesn’t house. If you need these following stated services or supplies, then you have to pay them by yourself or use a private insurance to handle the costs:
- Custodial care or long-term care
- Dental care (which is not associated directly with any major medical condition)
- Dentures or implants
- Eye exams for prescription glasses
- Cosmetic surgeries
- Ear exams and hearing aids
- Routine foot care
To avail some of these services mentioned above, you have to seek the assistance of Medicare Advantage Plans, private insurance plans or alternatives like dental discount plans.
Costs for Medicare Part B
For enrolling Medicare Part B, you have to incur costs like deductibles, premiums, copays, and coinsurance.
The monthly premiums that you pay depend on the time you register and your annual household income. Usually, the premium is paid via Social Security account. It is different from the premiums that involve other programs like Medicare Part C and Part D and Medigap. Apart from Social Security, Railroad Retirement Board and Personnel Management benefits are also used for monthly premium payments. If you don’t have any of these benefits, then you’ll get separate bills.
The standard premium expense for Medicare Part B in 2018 is around $134 or higher (based on the household income. However, individuals with benefits can have to incur around $130 or less than that. You’ll have to pay the standard premiums if:
- This is your first time participating in Medicare Part B.
- You are not eligible for Social Security benefits.
- You are directly charged for your Medicare Part B premiums, i.e., they are billed to your Social Security benefits.
- You have both Medicaid and Medicare, and Medicaid manages your premiums, i.e., your state pays the standard premiums.
- Your modified adjusted gross income as stated in your IRS tax return files from two years ago is greater than a specified amount. Along with the standard premium, you’ll have to pay an IRMAA (Income Related Monthly Adjustment Amount) which is an addition to your premiums.
When it comes to the deductibles, you have to pay around $183 at the beginning of every financial year.
Normally, you have to incur 20% of certain medical services such as outpatient therapy, durable medical equipment, and doctor’s services.
A copay is a type of out-of-pocket expense, which you will have to manage for outpatient hospital settings.
The expenses for Medicare Part B stated above are subject to change on an annual basis. Moreover, Medicare Part B doesn’t charge any form of out-of-pocket costs for preventive services like screenings or annual checkups.
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