Coverage Not Included in Medicare Part B
Medicare Part B does not offer coverage for routine dental, vision, or hearing benefits. It will also not provide coverage for services or treatments that are not considered medically necessary (this includes most cosmetic surgeries, plus all alternative forms of medical care such as acupuncture, acupressure, and homeopathy). Part B also does not cover outpatient prescription drugs as a rule and doesn’t cover most vaccinations and immunizations.
To conclude, Part B Medicare insurance is intended to pay for only a portion of medical bills, outpatient hospital and clinic charges, laboratory work, some home health care, physical and speech therapy, and very few drugs as well as medical supplies.
How much does Medicare Part B cost?
There are several things to consider when calculating the cost of Medicare Part B. Individuals will have a monthly premium, annual deductible, and coinsurance. Part B covers 80% of covered services after the annual deductible has been met.
Currently, the monthly premium for Medicare Part B is $164.90. This is the standard premium that many people pay. However, if an individual’s adjusted gross income is higher than a certain amount, the premium will be increased. If the individual is receiving Social Security benefits, Railroad Retirement benefits, or Office of Personnel Management benefits, the Part B premium will be automatically deducted from those monthly checks. Otherwise, Medicare may send a monthly bill that can be paid online with the Easy Pay method.
The Part B annual deductible is currently $226. Both the premium and deductible can be increased each year.
What copays does Medicare Part B have?
Part B does not have any copays.
Who is eligible for premium-free Part B?
The qualifications for Medicare Part B are similar to those for Part A and if you qualify for Medicare Part A without a premium, you’re also eligible for Part B.While most individuals pay a monthly premium for Part B, some lower-income beneficiaries and those who are eligible for both Medicare and Medicaid can qualify for premium-free Part B through the Medicare Savings Program.
The standard eligibility requirements for Part B are:
- You’re a U.S. citizen or a permanent legal resident who has lived in the U.S. for more than five years and,
- You are 65 or older
- You have been on Social Security Disability Insurance (SSDI) for two years
- You have end-stage renal disease (ESRD)
How to Apply for Medicare Part B
Individuals who have been receiving Social Security benefits prior to age 65 will automatically be enrolled in Medicare Parts A and B. A Medicare ID card will be sent to the individual’s mailing address the month before their 65th birthday. If an individual is not currently receiving Medicare benefits, they must apply for benefits themselves by either submitting an application online or calling the Social Security Administration office.
The Inital Enrollment Period for Medicare Parts A and B begins three months before an individual’s 65th birthday and continues until three months after their birthday. Unless the individual has other creditable health coverage, not enrolling during the Initial Enrollment Period will cause the beneficiary to incur a penalty.
The penalty will not be applied if the individual qualifies for a Special Enrollment Period. This enrollment period applies to those who did not enroll at age 65 but had other creditable health insurance. Look into other enrollment periods to get more insight into your enrollment options.
Reinstating Medicare Part B
If your Medicare Part B benefits get interrupted due to a lack of payment, individuals must get them reinstated by submitting a new application.
