Medicare Part B

Medicare Part B covers your preventive and medically necessary care. Everyone pays monthly premiums for Part B, which can come with an additional charge if you have a high income. Enrolling late will also result in an additional fee that can last as long as you hold coverage. Sign up on time to enjoy your benefits at the standard price.

Part B Coverage

Medicare Part B covers medically necessary and preventive services. That means along with necessary treatments, you can count on receiving vaccines and recommended screenings to help you and your doctor monitor and maintain your health.

Medically necessary services are standard accepted medical procedures that diagnose or treat medical conditions. These can include things like clinical research, ambulance services, mental health care, and durable medical equipment. 

Durable medical equipment includes items such as:

  • Blood sugar test strips
  • CPAP devices
  • Crutches
  • Infusion pumps
  • Traction equipment
  • Walkers
  • Wheelchairs

Medically necessary coverage also includes limited outpatient prescriptions, such as those used with an infusion pump, osteoporosis drugs, erythropoiesis-stimulating drugs, blood clotting factors, injectable or infused drugs, oral End-Stage Renal Disease medications, parenteral and enteral nutrition, IVIG, and transplant immunosuppressive drugs.

Preventive services help you to detect or prevent an illness. These services include things like:

  • Alcohol, Obesity, and Tobacco use counseling
  • Bone mass measurements
  • COVID-19, Flu, Hepatitis, and Pneumococcal shots
  • Diabetes self-management training
  • Glaucoma tests
  • Mammograms
  • Nutrition therapy services
  • Screenings for cancer, cardiovascular disease, depression, diabetes, and more
  • “Welcome to Medicare” initial visit
  • Yearly wellness visits

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Part B Costs

For Medicare Part B, you will be paying a yearly deductible along with your monthly premiums, your copayments, and your coinsurance. 

The Part B deductible for 2021 is $203. Once you reach this deductible, you can expect to pay 20% of the Medicare-approved amount for covered services.

The standard monthly Part B premium for 2021 is $148.50. You may have to pay more if you claimed a high income on your tax return. The standard rate applies to individuals who made less than $88,000 and married couples who made less than $176,000. If you made more than that, you will be charged an Income Related Monthly Adjustment Amount (IRMAA). Only a small portion of Medicare beneficiaries have to pay this increased rate because the majority are retired and have a smaller income. 

If you enroll in Part B outside of your Initial Enrollment Period, you may owe a late enrollment penalty. The late enrollment penalty for Part B adds 10% of the standard premium for every 12 months you went without signing up for Part B after you became eligible. Sign up on time to avoid paying this penalty, which lasts for the lifetime of your policy.

You may be able to find a Medicare Advantage plan that gives you a rebate for a portion of your Part B premiums. I can help you find the best coverage for your needs.

For help understanding your Medicare Part B coverage and costs in the Northern Illinois area, speak with me today.