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What is Medicare Part B?

Medicare Part B covers outpatient medical services and preventative care. Including, flu shots, colonoscopies, mammograms, and more.

Medicare Part B

  • Provider Services
  • Durable Medical
  • Home Health Services
  • Preventative Services
  • Ambulance Services
  • X-Rays & Lab Tests
  • Specialty Prescriptions

What does Medicare Part B coverage provide?

  • Provider Services: Services deemed medically necessary, most of the time this is going to be your doctor visit.
  • Durable Medical: Equipment that serves a medical purpose and long lasting.
  • Home Health Services: Coverage is provided when you are required to stay home and need skilled nursing or therapy care.
  • Preventative Services: These include flu shots, colonoscopies, mammograms, cholesterol screening, outpatient physical, and more.
  • Ambulance Services: This covers emergency transportation via ambulance.
  • X-rays & Lab Tests: X-rays ordered by your doctor have coverage.
  • Specialty Prescriptions: Certain select drugs may have coverage under Part B, otherwise drug coverage will be provided under Medicare Part D. Some drugs that may have coverage under Part B include, immunosupressants, anti-emetic, dialysis, or other drugs administered by a physician.
Medicare Part B Services

Medicare Part B coverage provides you access to a variety of outpatient medical services. Part B covers preventive care including flu shots, colonoscopies, mammograms and more. It covers ordinary outpatient things like doctor’s visits, lab testing, home health care, ambulance rides, and some chiropractic care too.

However, Medicare Part B also covers services that sometimes occur in the hospital.

This includes things like physician’s services, radiation or chemotherapy for cancer, surgeries, diagnostic imaging, medical equipment, and even dialysis for failing kidneys. Medicare Part B will also pay for drugs administered in a clinical setting, such as osteoporosis injections, infused drugs, antigens, and insulin that is used with an insulin pump.

Otherwise, outpatient drugs fall under Part D.

Part B is optional, but if Medicare is your primary coverage, you definitely need Part B. You also cannot get Medicare supplement coverage (Medigap) without it.

Medicare Part B provides coverage for normal outpatient medical services once admitted to a hospital and some homebound services administered by physicians and skilled nurses or therapists.

When is enrollment for Medicare Part B?

Those taking Social Security income benefits at age 65 will typically not need to enroll. The Social Security office will automatically enroll you. Your card generally arrives in the mail 1-2 months prior to your 65th birthday.

All others will need to apply for Medicare Part B themselves at age 65. This can be done online, over the phone, or in person at your local Social Security office. After applying, it generally takes 2-3 weeks for your card to arrive in the mail. So, it is best to ensure that you are applying several weeks prior to when coverage is needed.

To apply for both SS retirement benefits and Medicare at the same time, visit this link:
https://www.ssa.gov/retire

To apply for just Medicare, visit this link:
https://www.ssa.gov/benefits/medicare/

What is the Cost of Medicare Part B?

Part B Cost

For most Medicare Part B in 2021 has a premium of $148.50.

If you do not sign up for Medicare Part B when first eligible, you will incur the late enrollment penalty. This penalty is equal to 10% per year for every year that you waited to enroll. This penalty is applied to the $148.50 premium that Medicare Part B has, or to what you pay towards Medicare Part B premium.

A Late enrollment into Medicare Part B is when you do not apply for Medicare Part B when first eligible and do not have creditable coverage. Creditable coverage can include group coverage, work place coverage, and few others.

General costs associated with Medicare Part B:

  • Annual Deductible: $203
  • Coinsurance: You are responsible for 20% of the costs. There is no Out-Of-Pocket Maximum on original Medicare.
  • Excess: You are responsible for any excess charges that a provider or facility may charge beyond what Medicare reimburses.

The Coinsurance applies to most services, such as surgery and chemotherapy.

You do not necessarily need to be responsible for all of these costs, Medicare Supplement Plans and Medicare Advantage Plans are available to all that are on Medicare and can help in reducing the costs for many services.

If you have any other questions about Medicare Part B, or would like to take advantage of your free Medicare consultation with a local agent, request information below.

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