Original Medicare consists of two parts: Medicare Part A provides for hospital insurance, while Medicare Part B . Together, these two components are equal to Original Medicare, the federally administered health care program for seniors and certain persons with disabilities.
Medicare Part B covers medically necessary services and supplies, including medical visits, preventive care and sustainable medical equipment.
What does Medicare Part B cover?
Here are some examples of what Medicare Part B covers: Ambulance services:
- Transportation and travel to and from selected locations
- Chiropractic care for spine handling to correct subluxation (in medically necessary circumstances, when performed by a chiropractor or other qualified health-)
- Diagnostic tests and laboratory work Medical services, such as Office Visits Sustainable Medical Equipment (EMR) Home Health Services Physical
- Speech and Occupational Therapy Services Provided by a Certified Physical Physician
- Speech Therapist or Occupational Therapist Mental Health Services outpatient
- including partial preventive care services in hospital settings
- including screening and vaccines
- “Welcome to Medicare” and annual X-rays “Wellness”
If you are enrolled in a Medicare Advantage plan, you will always be covered by the same coverage of Medicare Parts A and B you would have had under the original Medicare plan. Medicare Advantage plans must offer at least the same level of coverage as the original Medicare plan, so that you will receive the same basic level of benefits you would have under the federal program. In addition, your Advantage Medicare plan may cover other benefits to keep you healthy, such as routine or dental vision, wellness programs, or prescription medications.
Read More: Is Medicare Part B Coverage Enough for Me?
How do I get Medicare Part B?
To be eligible for Medicare, you must be a U.S. citizen or legal permanent resident of at least five consecutive years and 65 years of age or older. You may also be eligible for Medicare insurance before age 65 if you have been receiving disability benefits from the Social Security or Railway Retirement Commission for at least two years, or if you have terminal kidney disease or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease). Like other parts of Medicare, there are rules regarding when you qualify and when you can register for coverage.
If you already receive pension benefits before age 65, you may be automatically enrolled in Part A or Part B of Medicare the month you turn 65. You are also automatically enrolled in the Medicare insurance plan if you have been receiving disability benefits from the Social Security Retirement Board or Railway for at least two years; you will be automatically enrolled in the 25th month of disability benefits. Individuals who are eligible for Medicare due to terminal kidney disease must register manually in Part B.
You can also register for Medicare Insurance Part B for the following periods:
- Initial Enrolment Period (IEP): This is the time when you are eligible to enroll in the Medicare insurance plan for the first time, either at age 65 or because of a disability. If you qualify because of your age, your initial registration period begins three months before the age of 65 and lasts seven months. If you are eligible for Medicare insurance due to a disability, your initial enrolment period begins three months before your twenty-fifth month of Social Security or Railway Pension Board disability benefits and lasts seven months.
- General Registration Period (GPP): If your initial registration period is missing, you can also register for Medicare Insurance Part B during this period, which runs from January 1 to March 31 each year. If you enroll in Medicare Insurance Part B during the general enrolment period, your coverage will come into effect on July 1 of the year you registered. If you did not register for Medicare Insurance Part B at the time you were first eligible, you may have to pay a late registration penalty, and your Medicare Part B premium may be 10% higher for each 12-month period that you could have benefited from Medicare Part B , but you decided not to get it.
- Special Enrolment Period (SEP): You can choose to delay your enrolment in Medicare Part B plan if you or your spouse are working and if you have group Medicare insurance based on current employment. When you or your spouse retire and lose your group Medicare insurance, you will be entitled to a special enrolment period to enroll in Part B. The special enrolment period is the period of eight months following the month in which the employer’s coverage ends or you cease to work ( whichever comes first). You can register each time you and your spouse remain covered by the group Medicare insurance plan or during the Special Enrolment Period.
You can enroll in Medicare Part B through Social Security in the following ways:
- Online Ssa.gov. If you are not ready to apply for pension benefits you can only apply for Medicare.
- In person in a local social security office.
- Call Social Security at 1(877)255-0284. TTY users can call 1(877)255-0284. Social security representatives are available Monday to Friday from 07:00 to 19:00.
If you work on a railway, you can apply for Medicare insurance through the Railway Retirement Commission, not the social security system. Contact the Railway Retirement Board to register at 1(877)255-0284 (TTY users, call 1(877)255-0284); Monday to Friday, 9:00 a.m. to 5:00 p.m.
What Does Medicare Part B Cost?
There is a premium associated with Health Insurance Part B by 2020, this premium is $144.60/month for most people who are 65 years old. If you enroll one of the highest income groups in medicare, you may have to pay more than that. This is the MRI (Monthly Adjustment of Income Premiums for Part B).
The Part B premium changes every year during most years. There is a provision to “maintain security” which prevents the increase in the Part B premium in years where there is no increase in the cost of living in social security benefits. In this case, the Part B premium would remain the same, although premiums for new care eligible for Medicare are higher. For this reason, sometimes different people pay different amounts for the same Part B benefits Most people choose to pay Part B contributions directly with their social security cheque.
This is by far the easiest way to pay premiums. However, if you do not already receive social security or do not want to pay it in this way, you have the option to get your quarterly Part B contributions paid.
While some individuals may qualify for Part A of the premium-free Medicare insurance plan if they have worked at least 10 years (40 quarters) and paid taxes during that period, most beneficiaries are required to pay a monthly premium for Medicare Part B insurance, unless they are eligible to low-income assistance. This amount of the premium may vary from year to year. Find out how much you may have to pay for your Medicare Part B premium here. If your income exceeds a certain threshold, you may need to pay a higher amount for Medicare insurance Part B coverage. This amount is known as the Monthly Income Adjustment Amount (AMR), which is an additional amount you will pay in addition to your monthly Part B contribution.
Social Security will contact you if this applies to you. In addition, certain personal expenses may be payable for services covered by Medicare Insurance Part B, including copayes, co-insurance, and Part B annual deductible Once you have reached your annual deductible, you will generally pay 20% of the amount approved by Medicare for most medical services and supplies. However, this may vary depending on the specific service or equipment.
Do you have any questions about what Part B of Medicare covers? Or you might be interested in finding additional benefits beyond original Medicare insurance, for example through a Medicare Advantage plan. If you want to discuss your Medicare insurance coverage options with a registered insurance agent, call Medicare ABC today for information on health plan options that can be tailored to your situation.
This website and its content are for informational purposes only. Nothing on the site should ever be used as a substitute for professional medical advice. You should always consult your doctor about the diagnosis or treatment of a health problem, including decisions about the right medication for your condition, as well as before performing a specific exercise or eating routine.
How Do I Sign Up for Medicare Part B?
Registering for Part B of the Medicare plan is very easy to do. First, if you already receive social security at age 65, you will automatically be enrolled in Parts A and B of health insurance. They will start on the first day of the month when he turns 65.
The only exception is if your birthday is the first of a month; in this case, your health insurance will start the first of the previous month. When can I register for health insurance part b If you do NOT receive social security as you approach your 65th birthday, you will not be automatically enrolled in Part B.
In this case, you will need to contact Social Security to register for Part B. The start date will remain the same — first day of the month you have 65 years old — unless you specify otherwise. You can contact Social Security at a local Social Security office or by calling 1(877)255-0284.
How Does Part B Work with My Medigap Plan?
If you have or are receiving a Medigap plan, your Part B of Medicare will be used as the primary coverage (along with Part A). The Medigap plan will fill the “gaps” that are not covered by Parts A and B. The different Medigap plans cover different gaps. You can read more about this on the Medigap coverage table.
callout29 A common question about Part B deals with overloads in Health Insurance Part B. These costs arise when a physician does not accept the “mission” of the Medicare plan (i.e. the schedule for payment of Medicare). A doctor can charge up to 15% above the schedule of payment of health insurance in the form of an “overload”. Some Medigap plans cover these loads, others do not. More information can be found here: Part B Excess Costs.