What is Medicare Part B?

What is Medicare Part B?

Medicare Part B helps cover medical necessities like doctor’s services, outpatient care, medical supplies and preventive services. Medicare Part B coverage is optional. However, if you want Part A, you must have Part B.

What is required to be eligible for Medicare Part B?

  • Age 65+ (under 65 for certain individuals with disabilities)
  • U.S. citizen or legal resident who has lived in the U.S. from at least 5 years

When to sign up for Medicare Part B?

There are some individuals who are automatically enrolled in Medicare Part B and some need to sign up manually. We can help you figure out when would be ideal for you to enroll.  It is specific to each person!  The Initial Enrollment Period for Part B starts 3 months before you turn age 65, includes your birth month and the 3 months after your birth month. If you do not sign up for Part B when you are initially eligible, you could be penalized with a “late enrollment penalty” if you do not have other creditable coverage. If you do have creditable coverage, you can enroll later if you have a Special Enrollment Period.

What is a Medicare Part B late enrollment penalty?

This late enrollment penalty will take the standard premium and increase it by 10% for each 12-month period that you could have had Medicare Part B.

What does Medicare Part B generally cover?

Medicare Part B will cover two specific types of services. One of those being medically necessary services, which is supplies or services needed to treat or diagnose a medical condition. The second service is preventive services which is  health care to detect or prevent an illness at an initial phase. The preventive services do not cost anything for the patient, if the service is offered by a health care provider that accepts assignment. Examples of things Medicare Part B will cover follows:

  • Mental health (outpatient or partial hospitalization)
  • Durable medical equipment
  • Ambulance services
  • Clinical research
  • Limited outpatient prescription drugs

What are the 3 factors that coverage is based on for Medicare Part B?

  1. Federal/State laws.
  2. National coverage decisions from Medicare
  3. State coverage decisions from companies that process claims for Medicare, indicating if coverage is medically necessary in the surrounding area.

What does Medicare Part B cost look like?

In 2019, the standard Part B premium is $135.50. These premiums are charged monthly and will be automatically deducted from your benefit payment if you are with Social Security, Railroad Retirement Board or Office of Personnel Management. If you are not receiving any of these benefits, you will receive a quarterly bill. There is a standard premium amount that most pay. If your modified adjusted gross income is over a certain amount, you might pay what Medicare calls a “Income Related Monthly Adjustment Amount”. This information is derived from the IRS, which is reported on the previous two-year tax returns.

What does Medicare Part B deductible and coinsurance look like?

In 2019, you will pay $185 annually. After this deductible is met, you will pay 20% of the Medicare-approved amount for doctor services, outpatient therapy, and durable medical equipment.

How can MWG Senior Services help you?

Our primary objective is to help you avoid penalties by enrolling in the right enrollment periods, while keeping your costs down as much as possible!  We know that is important to so many. If you have questions about navigating the ever-changing Medicare maze or retirement insurance options, we have advisors ready to light the way! Call us at (877) 759-5760 or email senior.services@morganwhite.com. It’s that simple!

To request a quote online, click https://mwgseniorservices.com/medsupp.