Topics we will cover in this section:
Part B (Doctor) Costs
For Medicare Part B, you’ll pay both a monthly premium and a yearly deductible. The monthly premium amount may vary depending on your specific situation:
- You’ll generally pay $148.50 (or higher depending on your income) for your monthly premium if any of the following applies to you:
- You aren’t receiving Social Security benefits.
- You’re billed directly for your Part B premium (it’s not taken out of your Social Security benefits).
- You have both Medicare and Medicaid coverage, and Medicaid pays for your monthly premiums. (Your state will pay the standard $148.50 premium).
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 lifetime higher premium, unless you’re eligible for a Special Enrollment Period.
In addition to your monthly premium, you’ll pay $203 for the yearly Part B deductible.
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 generally pay 20% of the Medicare-approved amount for doctor services, outpatient therapy, and durable medical equipment (DME). You may also owe a copayment for certain outpatient services. Following are the details of costs for certain Part B services.
Clinical Laboratory Services
You will pay $0 for Medicare-approved lab services under Part B.
Home Health Services
You will pay $0 for home health services, and 20% of the Medicare-approved amount for any durable medical equipment needed.
You will pay 20% of the Medicare-approved amount for doctor services (including doctor services received in a hospital setting), outpatient therapy, and durable medical equipment.
Outpatient Mental Health Services
For outpatient mental health services, you’ll pay:
- $0 for a yearly depression screening
- 20% of doctor visits to diagnose or treat your condition (the Part B deductible applies)
- If you are under care in a hospital outpatient setting, you may have to pay a copayment or coinsurance to the hospital
Partial Hospitalization Mental Health Services
For partial hospitalization mental health, you’ll pay:
- A percentage of the amount for each service you receive
- Coinsurance for each day of partial hospitalization services (the Part B deductible applies)
Outpatient Hospital Services
For outpatient hospital services, you will pay:
- For doctor services, you will pay 20% of the Medicare-approved amount (the Part B deductible applies)
- For other outpatient services, you will pay a copayment for each service
- For certain covered screenings and preventive services, you will pay $0
Note: If you have a Medicare Advantage plan, your costs may vary. Review your plan’s “Evidence of Coverage” to see what your costs will be. Though costs may differ, your Medicare Advantage plan will cover all of the same services as Original Part B.