Not a ton of people understand the importance of Medicare part B. We will break down how this part of medicare greatly impacts your preventative care and your daily use with Drs. and Labs.
How to read your Medicare Part B Explanation of Benefits.
You’ll be assigned to Part A and Part B when you first get Medicare. You’re automatically enrolled in Part A if you’re already receiving retirement benefits from Social Security or the Railroad Retirement Board when you turn 65. If not, you can sign up for it during your Initial Enrollment Period.
You can enroll in Part B any time during your Initial Enrollment Period as long as you’re not already receiving benefits from another retirement program. If you are, you’ll have to wait for the General Enrollment Period, which runs from January through March each year.
Your Medicare Part B premium is based on your income. Most people will pay the standard premium amount of $170.10 in 2022.
What does part B cover?
It covers two main types of services: medically necessary services and preventive services.
Medically necessary services are those that are needed to diagnose or treat your medical condition. They must be ordered by a doctor and considered reasonable and necessary for your care.
Preventive services are those that help prevent illness or detect it early when it’s easier to treat. These services are recommended by the U.S. Preventive Services Task Force and other medical organizations.
Part B also covers some limited outpatient mental health services, as well as durable medical equipment like wheelchairs and walkers.
What isn’t covered by Part B?
It doesn’t cover most long-term care, including custodial care, which helps with activities of daily living like dressing, bathing, and using the bathroom. It also doesn’t cover most dental care, eye exams for glasses or contact lenses, or hearing aids.
If you have any questions about what Part B covers or doesn’t cover, you can call the Medicare hotline at 800-MEDICARE (800-233-4225).
Are there any penalties for not taking part B with Medicare?
If you don’t enroll in it when you’re first eligible, you may have to pay a late-enrollment penalty. The penalty is an extra percent of the Medicare-approved amount for each 12-month period that you could have had Part B, but didn’t sign up for it. In most cases, you’ll have to pay this penalty for as long as you have Part B. You may not have to pay the late-enrollment penalty if you meet certain conditions, such as having coverage through a current or former employer.
Does Part B help with Drugs?
Most people with Part B have to pay the full cost of their drugs. However, there are some exceptions. For example, if you’re in a hospital or skilled nursing facility, Part B may help pay for some of your drug costs.
If you have limited income and resources, you may be able to get extra help paying for your drug costs.
To learn more about getting help paying for your drug costs, visit the Medicare website or call the Medicare hotline at 800-MEDICARE.
What are the limits on part B?
There are no limits on how much Part B will pay for medically necessary services and preventive services. However, there may be some limits on what you have to pay out-of-pocket for these services.
For example, you may have to pay a deductible, coinsurance, or copayment for some of these services. The amount you pay depends on the service and the provider you see.
What is the Part B deductible?
The Part B deductible is $233 in 2022. This is the amount you must pay before Medicare begins to pay for most of your Part B covered services.
After you pay your deductible, you usually pay 20 percent of the Medicare-approved amount for most doctor’s services (including most in-hospital care), outpatient therapy, and durable medical equipment. You also pay this 20 percent coinsurance for some preventive services.
Knowing the important parts of what is covered and what is not is important. Understanding what plans help you with the deductible and Coinsurance are also important to know. If you would like to look at what insurance options make the most sense for you. Please give us a visit at www.myunitedinsurance.com or call us at 1-800-339-4112
