Medicare Part B

Medicare Part B, along with Medicare Part A, make up what is called Original Medicare. As I noted in my previous Sixty and Me blog, Medicare Part A covers inpatient care in a hospital and skilled nursing facility, hospice care and home healthcare.

Medicare Part B covers the following costs if deemed medically necessary:

  • Doctors’ fees
  • Outpatient care
  • Home health services
  • Durable medical equipment

The Cost of Medicare Part B

Medicare Part B beneficiaries pay a monthly premium, unlike Medicare Part A, where few people pay a premium. The standard Part B premium amount for 2022 is $170.10. However, that amount goes up depending on income. For example, those making over $91,000 could pay from $238.10 to $578.30 per month.

Medicare Part B premiums are automatically deducted from the monthly benefit for those receiving Social Security. Otherwise, payment can be made through check, credit card or other methods.

Expect to pay deductibles, coinsurance and copayments under Part B. The Part B annual deductible for 2022 is $233. After this is paid, coinsurance of 20% applies although some preventative services have a $0 deductible or coinsurance.

Assignment

Medicare Part B coverage only applies if a provider accepts “assignment.” Assignment means that the provider accepts the Medicare reimbursement amount as payment in full.

Unfortunately, not all providers accept assignment. Some may not accept assignment at all or only for some services and not others. These providers are considered “non-participating.” This means the beneficiary pays all non-participating provider fees in full.

What Does Medicare Part B Cover?

Doctor Fees

As mentioned above, a significant part of Part B covers doctor’s fees. However, coverage is categorized as either medically necessary services or preventative services. Examples of preventive services are:

  • Annual “Wellness” checkups
  • Cancer screening
  • Cardiovascular disease screenings
  • Depression screenings
  • Mammograms
  • Nutrition and obesity screenings & counseling
  • Shots like COVID-19, flu and Hepatitis B

Outpatient Care

Medicare Part B covers outpatient services in contrast to Part A, which covers inpatient care. Examples of outpatient care are:

  • Emergency or observation services, including an overnight stay in the hospital
  • Outpatient clinic services, which could include same-day surgery
  • Laboratory tests and radiology services billed by the hospital
  • Mental health care
  • Medical supplies like bandages
  • Preventive and screening services

Home Health Services

Medicare Part B, like Part A, covers some home healthcare costs. Examples of Part B covered costs are:

  • Part-time skilled nursing
  • Physical, speech, or occupational therapy
  • Home health aide

A home health agency must be Medicare-certified to provide services. Also, in-home health services are covered only after a doctor has a face-to-face visit to certify the beneficiary needs such services.

Durable Medical Equipment

Durable medical equipment (DME- e.g. – wheelchair) costs may be covered under Medicare Part B if deemed medically necessary. The beneficiary pays only Part B deductibles and coinsurance if the DME supplier accepts assignment. DME can be either purchased or rented.

What’s Not Covered Under Medicare Part B?

There are some things Medicare Part B does not cover. Examples are:

  • Routine vision, hearing and dental care services and products (e.g. – eye exams or dentures).
  • Products promoting home safety like grab bars, stair lifts or medical alert systems.
  • Non-medical care in long-term care facilities. For example, Medicare will cover costs for help needed for daily activities like toileting, eating or dressing.
  • Medical services out of U.S. territory except in unusual situations.

You can learn more about Medicare Part B by checking out the Medicare website or downloading the latest Medicare and Me handbook. Also, look for my future blog posts on Sixty and Me for more valuable Medicare information. For an even deeper dive, check out my Medicare eBook at Cantissimo Senior Living.

Let’s Have a Conversation:

How have you used Medicare Part B thus far? Which of its benefits has been the most helpful to you? What service do you wish it covered?