Everything You Need to Know About Medicare Part B

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Learn about 2017 Part B costs below. Expect new costs to be announced for 2018.

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The Medicare Part B Wild Card

In 2016, Medicare provided healthcare for 56.8 million beneficiaries and spent $679 billion. The cost of providing Medicare Parts B and D to beneficiaries continues to rise, in large part due to the costs of prescription drugs.

The Medicare Part B monthly premium that you pay can vary due to many factors, including incremental yearly increases, the amount of income you earn, whether you enrolled in Part B late and are paying a penalty (a 10% increase per year you enroll late), and whether or not you are on Social Security. On average, the Medicare Part B premium has gone up 7.7% each year since 1966.

New Report from Social Security and Medicare Trustees

Social Security and Medicare trustees recently projected that the Part B premium will NOT increase for 2018, and that the Social Security cost of living adjustment would be 2.2%. These are only projections; the official announcement on next year’s Part B premium and Social Security’s cost of living adjustment will be made in the fall. Even if premiums don’t go up next year, it is likely they will continue to rise in the future, so stay tuned for updates and keep in mind for budgeting your next few years.

Projections were also made that Medicare’s hospital trust fund would run out by 2029 (one year later than previously predicted) and that overall Medicare Part B and D spending will rise by 7.8% and 6.4%, respectively, over the next 5 years.

Here are the basics on Part B costs for 2017.

What is Medicare Part B Coverage?

Original Medicare is made up of two parts: Part A and Part B. While Part A covers hospital stays, Part B focuses on medical insurance.

Medicare Part B 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 thwart illnesses or detect them at an early stage.

Medicare Part B Benefits

Medical services and supplies covered by Medicare Part B include (but may not be limited to):

  • Doctor visits
  • Clinical research
  • Laboratory tests and X-rays
  • Emergency ambulance services
  • Mental health services
  • Durable medical equipment (DME)
  • Preventive services, such as pap tests, flu shots, and screenings
  • Getting a second opinion before surgery
  • Rehabilitative services, including physical therapy, occupational therapy, and speech-language pathology services
  • Some outpatient prescription drugs

If in doubt, check to find out if Medicare covers a service or item.

Medicare Part B Costs

Medicare Part B involves 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 $109.00 for your monthly premium if you were enrolled in Part B before 2017.
  • If any of the following applies to you, you’ll generally pay $134.00 for your Part B premium:
    • You enroll in Part B for the first time in 2017.
    • 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 $183.00 for the yearly Part B deductible in 2017.

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.

Alternatives to Original Medicare Part B

If you feel you might need extra help paying your expenses, you can purchase a Medigap plan to help cover expenses for drugs for a chronic illness or other medical needs.

There are also Medicare Advantage plans (Medicare through a private insurer that covers Parts A and B and sometimes D) if you choose not to go with Original Medicare. You may not have Medicare Advantage and Medigap at the same time.

These alternatives incur the same Part B premium costs (plus the extra premiums of these programs), however with Medigap you have the peace of mind of knowing that your extra costs are covered, and with Medicare Advantage there is a maximum limit on what you can spend out of pocket per year on Part A and B expenses.

Related Links

2017 Medicare Part A and B Costs

Medicare Part A & B Won’t Cover These Services

What is Medicare Part A? A Simple Explanation

 

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Medicare World Editorial Team
The Medicare World editorial team works diligently to make sure our stories are informative, unbiased, and of utmost relevance to our readers. Our team of researchers and writers presents the best and latest information on all things Medicare, including legislation, enrollment rules, changes in coverage and costs, and health information. We enjoy keeping our readers up-to-date and helping them navigate the often-complicated Medicare maze.

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