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Medicare Part B

What Does Medicare  Part B Cover?

When you are turning 65, you’ll receive a medicare card, it is a paper red, white and blue card. On your medicare you will see “Medicare Part B Medical” which states the effective date of the coverage. Medicare Part A covers basically covers the hospital bed and Medicare Part B covers everything else including outpatient services. It covers the doctors, nurses, therapists, labs, x-rays, diagnostic testing, including radiology like MRI’s, CT scans, treatment for cancer, emergency room, and ambulance. Part B also covers certain injectables that you may receive at a medical specialist office such as a cortisone shots when your dealing with sciatica or erythropoietin (EPO) to build up your blood count when you’re anemic and chemotherapy treatment for cancer. Medicare Part B also covers durable medical equipment like wheels chairs, walkers, oxygen, hospital beds delivered to your home or diabetic supplies like blood glucose monitors, lancets, test strips and shoes and special shoes and inserts for those suffering from the disease. Renal dialysis for kidney failure is also a Part B coverage. Although it is your choice to enroll in Medicare Part b, keep in mind that you cannot have a medicare supplement or medicare advantage part c plan without Medicare Part B.

 

Some of the Things Part B Doesn’t Cover

 

Medicare Part B generally doesn’t cover hospital expenses because that is covered under Medicare Part A. It also doesn’t cover routine dental, glasses or hearing aids or routine foot care. It also doesn’t cover prescription drugs that are covered under Part D.

 

What Will I Pay for Medicare Part B?

While Medicare Part A generally doesn’t have a monthly premium, Part B does have a monthly premium. Most medicare beneficiaries will pay the standard monthly premium set by the Centers for Medicare and Medicaid (CMS). This amount may change at anytime but for 2018 the Part B premium is $134 for the majority of people turning 65 new to medicare. However this premium is based on your income, so if you have a high income you maybe subject to a higher Part B premium. Please contact your social security office or go online to ssa.gov to learn more about Medicare part b premium. You can also go to medicare.gov to get more information as well. If you do not enroll in Part B when your turn 65 you will face a late enrollment penalty unless you qualify for an exemption. For example if you have employer based coverage which is creditable, meaning that it is equal to or better than Medicare’s you not required to enroll in Part B when you turn 65. Once you lose your employer or group health insurance coverage you must enroll in Medicare Part B during a 2 month window of opportunity if your past your initial enrollment window. If you do not enrol in medicare part b when you’re eligible, you will have to pay a late enrollment penalty when you enroll at a later time. How much of a penalty might I pay?. Your monthly premium will go up by 10 percent for every 12 month period you were eligible and should have enrolled in Part B but didn’t.

 

Is There Any Cost Sharing Under Medicare Part B?

  • Medicare Part B deductible 2018 is $183
  • 20% of the Part B costs after Medicare generally pays 80%.
  • Any excess costs that a provider is allowed to bill beyond what Medicare normally reimburses the provider. This is generally up to 15% beyond what medicare generally pays the provider.

 

The largest cost involved is the 20% that you are subject to paying under Original medicare for Part B. Paying 20% of an office visit is not difficult to handle, however what if you had to pay 20% of major medical bills like chemotherapy, and since there is no cap to the 20%, your cost sharing could become quite substantial. Excess charges is the equivalent of balance billing that Medicare allows a provider to charge you. Since medicare is allowing the provider to charge you up to 15% over their normal reimbursement rate to providers, they are not going to pay for any of it. You can either purchase a medicare supplement or a medicare advantage part c plan to cover these cost sharing charges. Contact our medicare coverage helpline to speak with a licensed insurance specialist to learn more about reducing or eliminating your Part B cost sharing.

 

How Do I Enroll In Medicare Part B Coverage?

Because Medicare Part B has a monthly premium, you are not required to enroll in it, in other words you can turn down Part B. However if you want to signup there are somethings to know about Part B enrollment. If you are already receiving Social Security benefits at age 65 you do not need to do anything to enroll. The Social Security office will automatically enroll you. If your eligible at 65 then your initial enrollment period will begin 3 months before you turn 65. It includes the month of your birthday when you turn 65 and continues 3 months after your birthday month. If you for some reason don’t enroll Medicare Part B during the initial enrollment period, there will be another opportunity each year to sign up during a general enrollment period which begins Jan 1st and runs through March 31st. If you enroll during the general enrollment period, your Medicare Part B coverage will become effective on July 1st of the year you signup. If you would like more information on signing up for Medicare part b go online to medicare.gov or the ssa.gov medicare website.

 

Apply Online for Just Medicare Only

 

You can also apply for Medicare even though you’re not ready to retire just yet. You can go online to medicare.gov where you will find an online tool. There are no forms to sign and everything can generally be completed online and submitted electronically. The Social Security office will process your application and contact you if further documentation is needed. Once they have your application they’ll mail your Medicare card. Keep in mind that the Centers for Medicare and Medicaid Services (CMS) is responsible for managing medicare, the Social Security office handles the enrollment of people into Medicare. For more information about applying for medicare while delaying your retirement benefits, you may go here.

 

When to Apply for Medicare?

This is a common question I often hear, When Do I Apply for Medicare? You should make sure to sign up before you turn age 65, even if you’re not planning on receiving your retirement benefits just yet. Remember that Medicare becomes effective the 1st day of your birthday month if your apply before you turn 65. For example if your birthday is May 21st then Medicare will begin May 1st if you applied before May 1st. It may generally take 2-3 weeks before your medicare card will be delivered so do yourself a favor, give yourself plenty of time by applying early.

 

You can read our guide What Is Medicare which is available for download here or call a medicare specialist at Call 1-866-936-3831 1-866-936-3831.

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