MEDICARE PART BMedical Insurance / Outpatient Services
Medicare Part B
Premium: $164.90 (or higher depending on your income)
The amount can change each year, and you’ll pay the premium each month even if you do not use the coverage.
Deductible: $226, before Original Medicare starts to pay. This is a one time annual deductible.
Coinsurance: Typically you pay 20% of the cost for each Medicare covered service or item after you pay your deductible.
What you need to know about Part B:
- Coverage: Medicare Part B covers two types of services:
- Medically necessary services: These are services or supplies that are needed to diagnose or treat a medical condition and that meet accepted standards of medical practice.
- Preventive services: These are health care services that prevent illness or detect illnesses at an early stage, when treatment is likely to work best (like flu shots and screening tests).
- More specifically, Part B covers things like:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health (inpatient, outpatient, and partial hospitalization)
- Some outpatient prescription drugs
- Doctor visits
- Physical therapy
- Laboratory tests
- Cost: Beneficiaries typically pay a monthly premium for Part B. The premium amount can vary based on income. In addition to the monthly premium, there’s an annual deductible. After the deductible is met, beneficiaries typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
- Enrollment: Enrollment in Part B is optional. Some people automatically get Part B, but others need to sign up for it. If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have the coverage.
- Late Enrollment Penalty: If you don’t sign up for Part B when you’re first eligible, you might have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium could go up 10% for each 12-month period you were eligible for Part B but didn’t sign up for it.
Medicare Part B, in essence, is an essential component of the Medicare program, providing coverage for a broad range of outpatient medical services.