What is a Medicare Part B Plan?

Medicare Part B is medical insurance that is the second half of Original Medicare, while Part A is the first half. But what does Medicare Part B cover? Usually, Part B covers medical services that are essential to your health care needs. It also covers the cost of medical supplies needed for your medical services.

Specific examples of services and procedures that Part B covers include:

  • Ambulance services
  • Clinical research
  • Durable medical equipment
  • Lab tests
  • Mental health care
  • Orthotics
  • One initial “Welcome to Medicare” visit
  • Prosthetics
  • Preventative care
  • Yearly wellness visits

In addition to these services, Part B plans also cover outpatient prescription drugs, but only up to a certain limit. For personalized prescription drug coverage, you will need to sign up for Part D coverage.

Coverage for Part B can vary from plan to plan, especially if you have a Medicare Advantage plan. However, due to federal regulations, your coverage must be at least equal to Original Medicare coverage.

Plans usually bundle Medicare Parts A and B together. On its own, Part A may be available with no premium. However, Part B plans do include a premium.

How Much Does Medicare Part B Cost?

Fortunately, Medicare Part B Premiums are usually automatically deducted from your disability or retirement benefits. Specifically, if you receive payment from Social Security, the Railroad Retirement Board, or the Office of Personel Management, then the payment will be taken care of for you.

On the other hand, if you do not receive any of these benefits, you will be responsible for paying the premium on your own.

The cost of Part B premiums is based on your gross monthly income levels. The base cost in 2020 is $144.60. Most Medicare beneficiaries will pay the base amount.

The amount you pay is determined by Medicare from the most recent tax return reports available to the Social Security service. Medicare then looks at your modified adjusted gross income and places you within the appropriate premium tier.

Note, however, that Medicare can only access reports from two years prior to your coverage. The reason they can only access these two-year-old reports is that they are the most recent reports available to the Social Security office.

In addition to a premium, beneficiaries will also pay an annual deductible. In 2020, the deductible was set at $198. Once the deductible is met, Medicare will cover 80 percent of the cost for approved services.

There are several requirements you must meet before receiving Medicare Part B coverage.

How Do I Sign Up for Medicare Part B?

Medicare Eligibility

First, you must be eligible for Medicare benefits. For most people, you will be eligible for Medicare when you turn 65. Usually, you will be enrolled in both Medicare parts A and B when you turn 65.

However, if for some reason you are not enrolled automatically, you can fill out a Medicare Part B application during your enrollment period. This enrollment period includes the three months before your birthday, the month of your birthday, and the three months after your birthday.

If you sign up after this initial enrollment period, you will be charged a late enrollment fee. You will be charged late enrollment fees as long as you receive Medicare coverage.

Late Enrollment Fee Exceptions

General Enrollment

Alternatively, if you did not sign up during your initial enrollment period, or if you do not qualify for a Special Enrollment Period, you may sign up during General Enrollment. Should you qualify for one of these enrollment periods, you will not have to pay late enrollment fees.

The General Enrollment Period opens every year on January 1st and closes March 29th.

If you do sign up during this time, you will be responsible for paying the Part B premium. If you also sign up for Part A, you will also have to pay the Part A premium.

Special Enrollment Period Qualifications

There are two different Special Enrollment Period options depending on your situation. First, you may be able to sign up for Medicare at any time if:

You are working

Your spouse is working

You or your spouse has group plan coverage.

Your group plan coverage may come from either an employer or through a work-related union.

Secondly, you may be eligible for an 8-month Special Enrollment Period the month after one of the following:

End of employment

The end of the work-related group plan coverage

What’s the Difference Between Medicare Part B and Medicare Advantage?

Some people may confuse Medicare Advantage plans with Original Medicare plans. However, Original Medicare is a combination of Parts A and B and is covered by the federal government. On the other hand, Medicare Advantage plans are offered and provided by private insurance companies.

There are also several types of Medicare Advantage Plans, including Special Needs Plans, Prescription Drug Plans, and Medicare Supplement Insurance.

Medicare Can Be Complicated, We Make it Simple

If you need help signing up for Medicare Part B coverage come visit Buffalo Health Advisors. Our health insurance agents have many years of experience helping people get the coverage that they need. We also have some helpful videos that answer frequently asked questions about Medicare that you can view here on our website.

Let Us Help You Find The Right Plan

At Buffalo Health Advisors, we believe in providing solutions to individuals as they transition to Medicare plans. We can help you understand the benefits of both Original Medicare Plans and Medicare Advantage Plans. We will help you find the right plan that will help you protect your health, while also protecting your overall wealth.

Visit or call our Nashville, TN office to learn more about all of your Medicare options at no cost to you.

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