Medicare Parts in More Detail and What They Mean For You – Part B

MEDICARE PART B

PART B – Ok so what is PART B? Part B is a part of what is know as Original Medicare remember that Original Medicare has 2 parts: Part A and Part B = Original Medicare. Part B covers several medically necessary outpatient services. So, what is an outpatient service. An outpatient service is a service that is medically necessary for example it must be diagnosed or treated as a health condition.

PART B – SERVICES COVERED: Here are some examples of the services that Part B covers; Emergency ambulance, chemotherapy, durable medical equipment, emergency room care, occupational therapy, physical therapy, diabetic screenings, vaccinations for the flu, hepatitis B, and more (to see the full list of benefits please visit (www.Medicare.gov).

PART B – SERVICES NOT COVERED – It is important to understand that Medicare PART B does not cover everything, also really important to keep in mind that you must keep paying for your Medicare Part B premium and there may be some associated deductible and it only pays for about 80 percent of the medical service after you have satisfied your premium and deductibles (Original Medicare).

This is a list of the things Medicare Part B does not cover. Routine physical, examinations, most prescription drugs, dental care, no dentures, most vision care, including eyeglasses, or contact lenses, hearing aids, long-term care, cosmetic surgery, massages, acupuncture, and chiropractic.

If you are looking for additional coverage to complement your Original Medicare, you may want to consider Medicare Part C or otherwise know as Medicare Part C. Give us a call at 559-343-2333 or email me at Rolando@YourMedicarecoverage.net and we will help you navigate this maze called Medicare making it clear, simple, and understandable.

PART B – WHO IS ELIGIBLE – So you want to know who is eligible, this seems to be one of the easier things to answer about Medicare. 1) Those who are 65 and older; 2) people with eligible disabilities; 3) individuals with end-stage renal disease. You also must have Medicare Part A to be eligible for Part B when you are first eligible to enroll, and this is typically when you turn 65 years old.

There are circumstances when you do not qualify for Part A because you have not paid enough taxes under these circumstances you can buy Part A and then enroll in Part B. These and others are special situations, and you should speak to a Medicare Expert about your current situation to explore your options.

PART B – HOW MUCH DOES MEDICARE PART B COST (2021) – This is the age-old question. How much does Part B cost? As of 2021, your monthly premium shall cost you $148.50. If you have a high income you may have to pay more for your part B. This is determined by income-related monthly adjusted amount (IRMMA) and will be calculated based on your previous year’s tax return.

PART B – DEDUCTIBLES – A deductible is what you must pay before PART B starts to pay for services. The Part B deductible for 2021 is $203.00.

PART B – COINSURANCE – Coinsurance is the percentage you pay after you have paid your deductible for Part B. Your coinsurance shall be 20 percent of the cost.

PART B – COPAY – Is what you must pay when you receive medical services. For example, you go to your doctor and you must pay $20.00 this is a copay. You may be required to have a copay at the Hospital if you have outpatient service.

PART B – LATE ENROLLMENT PENALTY – If you do not enroll when you are first eligible then you must pay a penalty. Why is there a penalty, Medicare is federal health insurance, and it relies on people who are not sick to support the system so that it can help the people who are sick. If you get penalized your monthly premium may increase 10 percent of your standard premium for each 12-month period that you did not enroll, and you will pay this as long, as you are enrolled in Medicare Part B.

PART B – WHEN CAN I APPLY – Initial enrollment Period: This is a 7-month period when a beneficiary can enroll into Original Medicare around his 65 Birthday. This period begins 3 months before your 65th birthday and 3 months after your birthday and it does include your birthday month. if you enroll during this Initial Period you will avoid any penalties.

Open Enrollment Period: There is a period called as the “open Enrollment Period” this period is from October 15 through December 7. This is the period when you can where you can change from original Medicare to Part C or From Part C back to original Medicare. You can also change from Part C plans to other part C plans and add or remove part D.

General enrollment period: If for some reason you forgot to enroll into Medicare during the “Initial Enrollment Period” Medicare give you another opportunity to enroll from January 1 through March 31.

Special Enrollment Period: Sometimes you cannot enroll into Medicare because special circumstances arise in life, So, you may enroll later into Medicare if you have a special reason or otherwise know as “Special Enrollment Period”. A great example of this is, you are 65 but you are still working and still get medical coverage provided by your employer. You decide to retire and are left with no insurance you have 8 months to enroll into Medicare. You will most likely not pay a penalty fee during an applicable special enrollment period. For the complete list of special enrollment periods for Part B please visit (www.Medicare.gov).

So, to Summarize. Medicare Part B is a Part of Original Medicare that will help you cover medically necessary outpatient service. You must get Part A to get Part B. You must pay a premium for Part B ($148.50) for 2021 and maybe more if you are high earner, it will be based on your previous years declared income. You must pay a deductible before Part B starts to pay for services ($203.00). You must pay 20 percent of the remaining cost for medical service and you may be required to pay for copayments. As you can see this can add up very quickly. If you do not sign up for Medicare Part B when you turn 65 you may pay a penalty 10 percent of the premium amount for the duration you were not covered on Medicare Part B. for life. You must sign up during certain Periods: 1) Initial Enrollment Period; 2) Open Enrollment period; 3) Special Enrollment Periods.

If you would like to find out information about reducing your cost through a Medicare Advantage or Medicare supplement plan please do not hesitate to call me at 559-343-2333 or email me at Rolando@Yourmedicarecoverge.net we will make this process clear, simple and understandable.