This article was originally published on June 20, 2016, and updated on June 26, 2017.
What is Medicare Part B coverage?
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
If in doubt, check to find out if Medicare covers a service or item.
Medicare Part B involves some 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.
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.
The new Medicare Plus Card saves you up to 75% on things not covered by Medicare
Medicare doesn’t cover everything. Luckily, those on Medicare can now start saving on out of pocket expenses like prescription drugs, dental, vision, hearing, and more. Over 1 million people have already received their free Medicare Plus Card.