Medicare Part B, along with Medicare Part A, make up what is called Original Medicare. As I noted in my previous Sixty and Me blog, Medicare Part A covers inpatient care in a hospital and skilled nursing facility, hospice care and home healthcare.
Medicare Part B covers the following costs if deemed medically necessary:
Medicare Part B beneficiaries pay a monthly premium, unlike Medicare Part A, where few people pay a premium. The standard Part B premium amount for 2022 is $170.10. However, that amount goes up depending on income. For example, those making over $91,000 could pay from $238.10 to $578.30 per month.
Medicare Part B premiums are automatically deducted from the monthly benefit for those receiving Social Security. Otherwise, payment can be made through check, credit card or other methods.
Expect to pay deductibles, coinsurance and copayments under Part B. The Part B annual deductible for 2022 is $233. After this is paid, coinsurance of 20% applies although some preventative services have a $0 deductible or coinsurance.
Medicare Part B coverage only applies if a provider accepts “assignment.” Assignment means that the provider accepts the Medicare reimbursement amount as payment in full.
Unfortunately, not all providers accept assignment. Some may not accept assignment at all or only for some services and not others. These providers are considered “non-participating.” This means the beneficiary pays all non-participating provider fees in full.
As mentioned above, a significant part of Part B covers doctor’s fees. However, coverage is categorized as either medically necessary services or preventative services. Examples of preventive services are:
Medicare Part B covers outpatient services in contrast to Part A, which covers inpatient care. Examples of outpatient care are:
Medicare Part B, like Part A, covers some home healthcare costs. Examples of Part B covered costs are:
A home health agency must be Medicare-certified to provide services. Also, in-home health services are covered only after a doctor has a face-to-face visit to certify the beneficiary needs such services.
Durable medical equipment (DME- e.g. – wheelchair) costs may be covered under Medicare Part B if deemed medically necessary. The beneficiary pays only Part B deductibles and coinsurance if the DME supplier accepts assignment. DME can be either purchased or rented.
There are some things Medicare Part B does not cover. Examples are:
You can learn more about Medicare Part B by checking out the Medicare website or downloading the latest Medicare and Me handbook. Also, look for my future blog posts on Sixty and Me for more valuable Medicare information. For an even deeper dive, check out my Medicare eBook at Living50+.
How have you used Medicare Part B thus far? Which of its benefits has been the most helpful to you? What service do you wish it covered?