Understanding Medicare Part B
For Medicare recipients, Part B is your medical insurance. It is one of two parts that make up Original Medicare.
Part B helps to cover costs for a wide range of medical services that extend beyond inpatient treatment. This coverage includes both medically necessary services and preventive services.
Some choose to defer Part B enrollment -- a decision often influenced by current health insurance coverage or employment status. However, even if you have private or employer insurance, Part B can be used in coordination with your current coverage to reduce spending.
If Medicare is your primary coverage, then Part B is strongly recommended.
Am I Eligible for Medicare Part B?
If you are eligible for Medicare Part A, then you are also eligible to enroll in Part B coverage.
So, just like for Part A eligibility, if you are the age of 65 or older, a U.S. Citizen or Permanent Legal Resident of at least 5 consecutive years, then you are eligible for Medicare Part B.
Some are eligible for Medicare before they turn 65. If you are already receiving retirement or disability benefits, you are likely eligible for Medicare Part B. Medicare deducts the cost of your Part B monthly premium from your Social Security check.
How Do I Enroll in Medicare Part B?
If you are already receiving Social Security benefits then you will be automatically enrolled in Medicare Part B (along with Part A).
In this case, your Medicare card will arrive in the months leading up to your 65th birthday. And your coverage will begin on the first day of your 65th birthday month.
If you are already receiving Social Security benefits but do not wish to enroll in Part B, you can notify Social Security of this decision and return your card.
If you are not receiving Social Security benefits you will need to sign up for Part B through Social Security.
If you aren’t collecting these benefits, then you can enroll in Medicare during your Initial Enrollment Period, which begins three months prior to your 65th birthday.
There are three options for signing up:
If you are enrolling in Part B, the best time to do so is during your Initial Enrollment Period.
Your Initial Enrollment Period is seven months long: it begins 3 months prior to your 65th birthday month, includes your birthday month, then extends 3 more additional months.
Important: If you missed enrolling for Part B during your Initial Enrollment Period, you are locked out of Part B coverage until your next available enrollment period.
Your next chance to enroll in Part B is during General Enrollment. The General Enrollment Period runs from January 1 to March 31. Your coverage will then begin later on July 1 of that year.
Penalty for Part B Late Enrollment
Generally, if you don’t sign up for Part B during your Initial Enrollment Period, you will have to pay a penalty for late enrollment.
Your monthly premium cost goes up 10 percent for every 12-month period you didn’t enroll in Part B while eligible.
This penalty follows you for as long as you have Part B. The 10 percent increase is only applied after a full 12-month period.
Part B covers both medically necessary services and preventive services.
This includes some of the more expensive services you might experience during a hospital stay, such as:
Part B also covers preventative medical services like:
Additionally, Part B covers a number of preventative care measures such as:
Medically Necessary Services –
Services and supplies used for diagnosis and treatment of medical conditions. These services and supplies must meet the accepted standards of medical practice.
This includes the use of medical equipment like wheelchairs, hospital beds, and oxygen equipment.
Preventive Services –
Healthcare to prevent illness or detect it early enough for optimal treatment. This includes diagnostic tests like MRIs, EKGs, CT scans, and X-rays.
It also applies to covered screenings such as pap tests, HIV screening, glaucoma tests, hearing tests, diabetes screening, and colorectal cancer screenings.
How Much Does Medicare Part B Cost?
Part B Premium for 2020 –
For most new enrollees, your Part B standard monthly premium for 2020 is $144.60.
Your premium amount is based on your annual income, so if your income exceeds $87,000 ($174,000 for married couples), then your premium will be higher.
Part B Deductible for 2020 –
Your Part B annual deductible for 2020 is $198.
This means that once you have met this amount (used or been provided $198 worth of Part B covered services), you will then start to pay 20% of the cost for Part B covered services going forward that year (while Medicare covers the other 80%).