Medicare Part B is one of the most important aspects of Medicare. It covers medically necessary services, such as doctor visits, outpatient care, and some preventive services. In this blog post, we will take a closer look at how Medicare Part B works in 2022. Also, what you can expect to pay for it. We will also discuss ways that you can save money on your Part B premiums.
What is the Cost?
In 2022, the standard monthly premium for Part B is $170.10, which is either deducted from your Social Security benefits or paid out of pocket. Part B coverage makes sense for most individuals due to its cheap monthly premiums. You should evaluate your current health insurance coverage before enrolling in the federal plan.
Part B Covers
Medicare Part B is a portion of Original Medicare, which is the federal health insurance program for individuals who are 65 and older or who have a qualified disability.
Part B is known as the medical insurance portion of Medicare. This means it provides coverage for preventive and other medical services. Medicare Part A provides coverage relating to hospital expenses.
Some examples of Medicare Part B expenses include:
- Ambulance services
- Lab tests
- Doctor visits
- Some medical equipment
- Therapy
- Screenings
- Vaccinations
- Transplants
Eligibility and Enrollment of Part B
Medicare Part B is available to U.S. citizens and legal residents who fall under one of the following criteria:
- Over the age of 65
- Under the age of 65 with a disability
- Have end-stage renal disease
- Have Lou Gehrig’s disease (ALS)
If you contributed to Social Security while working and are getting benefits for at least four months before turning 65, you will be enrolled in Medicare Part A automatically. You’ll also be enrolled in Part B, but you can choose to decline it since you must pay a separate monthly fee for Part B insurance.
If you do not receive benefits from Social Security, then you’ll need to manually enroll in Medicare Part B. Enrollment begins three months before your 65th birthday and ends three months after the month you turn 65, for a total of seven months.
During this initial enrollment period, you can sign up for any part of Original Medicare. When you enroll before the month you turn 65, coverage begins on the first day of your birth month. If you sign up the month you turn 65 or in the final three months of your enrollment period, your Medicare policy will be effective on the first day of the following month.
If your birthday falls on the first day of the month, your seven-month enrollment period starts and ends one month sooner. It begins four months before you turn 65 and ends two months after your birth month. If you enroll four months before your 65th birthday, your Medicare policy begins a month earlier as well. For example, Medicare would start on June 1 for a person whose birthday falls on July 1.
Changes for 2022
In 2022, the standard Medicare Part B premium jumped by $21.60 — the largest dollar increase in the program’s history. The rate went up partly to pay for an expensive new Alzheimer’s drug called Aduhelm. The Food and Drug Administration (FDA) approved it at a very high cost. But in a rare move, the drug maker greatly reduced the price of Aduhelm — after Part B premiums were established for 2022.
Due to the decreased drug price, the Centers for Medicare & Medicaid Services (CMS) is looking into lowering the 2022 Part B rate. Reducing the rate would be unprecedented and would provide relief to Medicare recipients this year, but long-term solutions are needed. One option being discussed by Congress is the Elijah E. Cummings Lower Drug Costs Now Act, which would cap drug prices and empower Medicare to negotiate costs.
The Part B Deductible
Medicare Part B comes with an annual deductible amount that must be met before coinsurance or copay benefits kick in. In 2022, the deductible amount is $233, meaning that after you pay out of pocket for expenses that total $233, cost-sharing begins.
Typically, after you reach the deductible for the year, you are required to pay 20% of Medicare Part B approved expenses out of pocket.
Programs That Help With Your Premium and Deductibles
If you’re struggling to pay your Medicare Part B premium and deductible, there are a few programs that may be able to help. The two main programs are Medicaid and the Extra Help program through Social Security.
Part B Giveback Plans
Private insurance companies that offer Medicare Advantage plans (Part C) and other types of Medicare health plans may also offer Part B giveback plans. With this type of plan, you pay your Part B premium to the insurance company instead of to CMS. The insurer then pays it on your behalf to CMS. In return for paying your monthly premium, the company may offer you a lower deductible or coinsurance, or both.
Keep in mind that if you decide to enroll in a Part B giveback plan, you’re still responsible for any other Medicare costs, such as the Part A premium (if you have to pay one), deductibles, and coinsurance. Also, these plans aren’t available in all areas.
Part B giveback plans may be a good option if you’re looking for ways to lower your Medicare costs and you’re comfortable with the idea of having a private insurer manage your Part B coverage. But make sure to carefully compare these plans with other types of Medicare health plans before enrolling. If you have any questions, give us a call at 800-339-4112.