Medicare Part B – Medical Insurance
This article was updated on: 07/25/2016
What is Medicare Part B coverage?
Medicare Part B (medical insurance) helps cover medically necessary services and supplies needed for the diagnosis or treatment of your health condition. This includes outpatient services received at a hospital, doctor’s office, clinic, or other health facility. Medicare Part B also helps cover many preventive services to prevent illness or detect them at an early stage. Together, Medicare Part A and Part B are known as Original Medicare.
Medicare Part B benefits
Medical services and supplies covered by Medicare Part B include (but may not be limited to):
- Doctor visits
- Laboratory tests and X-rays
- Emergency ambulance services
- Mental health services
- Durable medical equipment
- Preventive services, such as pap tests, flu shots, and screenings
- Rehabilitative services, including physical therapy, occupational therapy, and speech-language pathology services
Medicare Part B costs
You’ll pay both a monthly premium and a yearly deductible for Medicare Part B. The monthly premium amount may vary depending on your specific situation:
- You’ll generally pay $104.90 for your monthly premium if you were enrolled in Part B before 2016.
- If any of the following applies to you, you’ll generally pay $121.80 for your Part B premium:
- You enroll in Part B for the first time in 2016.
- You aren’t receiving Social Security or Railroad Retirement Board benefits.
- You’re billed directly for your Part B premium.
- You have both Medicare and Medicaid coverage, and Medicaid pays for your monthly premiums.
You may have to pay a higher premium if your yearly income is above a certain amount, as reported on your tax return from two years ago. In addition, if you didn’t enroll in Medicare Part B when you were first eligible, you may have to pay a late-enrollment penalty in the form of a higher premium, unless you’re eligible for a Special Enrollment Period.
In addition to your monthly premium, you’ll pay $166 for the yearly Part B deductible.
For individual services and supplies, your Medicare Part B costs may vary. Some preventive services are completely covered if your provider accepts Medicare assignment. If the Medicare Part B deductible applies, you must pay all costs until you meet the yearly deductible amount before Medicare begins paying its share.
After your deductible is met, you typically pay 20% of the Medicare-approved amount for the service. You may also owe a copayment for certain outpatient services.
Did you know that some Medicare Advantage plans may offer additional services beyond Medicare Part B? For example, some Medicare Advantage plans include benefits like wellness programs and routine vision and dental benefits. These benefits aren’t normally covered by Medicare Part A or Part B.
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