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Part B
What is Medicare Part B?
Medicare Part B is one of the two parts of Original Medicare and provides medical coverage. Beneficiaries who are eligible for the Medicare Part A They are also eligible to enroll in Part B once they are eligible for Part A.
Medicare Part B is a voluntary program that requires you to pay a monthly premium for all months of coverage.
What does Part B cover?
How do I find out if Medicare covers what I need?
- Talk to your doctor or other health care provider about why you need certain services or supplies. Ask if Medicare will cover them. It is possible that you need something that is usually covered, but your provider believes that Medicare will not cover it in your situation. If so, you will need to read and sign a notice. The notice says that you may have to pay for the item, service, or supply.
- Find out if Medicare covers your item, service, or supply.
What factors determine Medicare coverage?
- Federal and state laws.
- National coverage decisions made by Medicare about whether something is covered.
- Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide if something is medically necessary and should be covered in your area.
What is not covered by Part B?
- Most dental care.
- Eye exams related to the prescription of glasses.
- Dentures.
- cosmetic surgery.
- massage therapy
- Routine physical exams.
- Acupuncture.
- Hearing aids and tests to adapt them.
- Long term care.
How much does Part B cost?
Part B Premiums
The standard Part B premium amount in 2021 is $148.50 and most people will pay this amount. However, if your modified adjusted gross income is above a certain threshold, you may pay an Income Related Monthly Adjustment Amount (IRMAA).
Your Part B premium will be automatically deducted from your benefit payment if you get benefits from one of the following:
- Social security
- Railroad Retirement Board
- Personnel Management Office
If you do not receive one of these benefit payments, you will receive a quarterly bill for your Medicare Part B premium.
Late Enrollment Penalty
If you didn't get Part B when you were first eligible, your monthly premium may go up 10% for each 12-month period you could have had Part B but didn't sign up. In most cases, you will have to pay this penalty each time you pay your premiums for as long as you have Part B.
Part B deductible and coinsurance
In 2021, you'll pay $203 toward your Part B deductible. After you meet your yearly deductible, you typically pay coinsurance of 20% of the Medicare-approved amount for the following approved services:
- Most medical services (even while you are in a hospital)
- outpatient therapy
- Durable Medical Equipment (DME)
