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Medicare Part B

People often describe Medicare Part B as medical coverage outside of the hospital. However, this is not entirely accurate. Medicare Part B covers things in and out of the hospital and should be viewed more as coverage facilitated and ordered by a doctor.

Medicare Part B covers many outpatient medical services, including preventive and ordinary services like mammograms, colonoscopies, flu shots, and more. Doctors’ visits and lab tests are also covered, and some chiropractic care and ambulance rides can also be covered.

Part B covers things that happen in the hospital too. Medicare Part B covers chemo and radiation for cancer treatments, medical equipment, and imaging services.

Do I have to get Medicare Part B

Medicare Part B

Remember, even though Part B is optional, you need it if you have Medicare as your primary coverage. You can not purchase a Medigap plan without Medicare Part B. Medicare Part B has a monthly premium you must pay each month. The government sets that premium amount, and most people will pay the set rate. For 2023, the tip is $164.90 for newly enrolled Medicare members. While this sounds like a lot of premium, the Federal Government is picking up the other 75%.

If your income is above a certain amount, you may be required to pay more. Less than 5% of Medicare members typically pay more than the set monthly premium.

A penalty fee may also be attached to your Part B premium if you enroll late to Part B. This penalty fee is for life, so it is essential to know when your enrollment window is and not miss it! This window can be when you retire and lose access to your group benefits through an employer. If you do not know when your enrollment window is, please get in touch with us to help you sort through those questions.

Signing Up for Medicare Part B

Medicare Part B and Prescriptions

People already receiving Social Security benefits before age 65 don’t have to enroll because the Social Security office automatically enrolls you. You will receive your card in the mail a month or two before your 65th birthday. Everyone else needs to enroll in Medicare Part B when they turn 65. It takes several weeks to process your application and receive the card, so make sure you apply a bit before you need the coverage. You can sign up online at the local Social Security office or on the phone.

Medicare Part B will not cover any medical expenses covered by Medicare Part A., Dental care, vision, hearing, cosmetic, or foot care. Medicare Part B does not cover prescription medications you would pick up in a pharmacy, and retail pharmacy medications require a Medicare Part D drug plan.  

Costs of Medicare Part B

You will pay a percentage of the costs of your Medicare Part B services. These costs generally include your annual Medicare Part B deductible of $226.00, 20% of the remaining costs (no caps or limits on the 20%), and any excess charges you may incur above what Medicare pays. That 20% cost-sharing can be significant for your care, depending on your services. The 20% cost-share on cancer treatments and surgeries can add up quickly. However, there is no reason to fear this because many supplement coverage options are available. We can help you find a good fit for your budget. Another cost associated with Part B is the Part B excess charge. This is a charge that a doctor can charge you if Medicare contracts them but does not accept Medicare Assignment.

Part B Deductible Warning

If the Medigap Plan you choose does not pay the Part B Deductible, do not pay it at the doctor’s office. Instead, tell them to process it through Medicare and then bill you. This is the standard operating procedure and could save you many headaches later in the year with another doctor.

You can protect yourself from major medical expenses by having a Medicare Supplement or Medicare Advantage plan. There are differences between states and procedures, so contact us for a personalized plan to fit your needs by calling 352-508-4221 or contacting us.