Medicare B - Understanding the Program

Medicare B – Understanding What the Program Is

Medicare is a national health insurance program designed, for the most part, individuals 65 years of age or older. Medicare is divided into a variety of parts, the most common being Medicare Part A and Medicare B. Medicare Part A helps cover costs of hospitalization services, while Part B helps pay for, at its most basic definition, physician-based and other medical services. Most people receive Medicare Part A hospital insurance for free if they've paid into the Medicare health system through employment taxes for at least 10 years.

Medicare Part B

What Does Medicare Part B Cover?

Medicare Part B helps pay for services such as:

  • Physicians’ services.
  • Outpatient hospital care.
  • Physical and occupational therapists.
  • Home health care.
  • Preventive services and treatments, including preventive colorectal cancer screenings, cardiovascular screenings, glaucoma tests, bone mass measurements, lab services, diabetic screening and diabetic supplies.
  • Some Home Health Services (medically necessary) including part-time and skilled nursing care.
  • Ambulatory surgery center fees for approved services.
  • Flu shots.

For a full list of coverage, options and premiums for Part B Medicare, access the government's Medicare Web Site

What Does Medicare B Cost?

Medicare Part B requires premium payments that average about $96.40 for most individuals, with premiums deducted from Social Security benefit checks. However, new enrollees or those who don't receive security benefits for Medicare Part B beginning January 1, 2010 may pay approximately $110.50 premiums.

Premium payments are determined by income, and individuals who file individual tax returns of over $85,000 as of 2008 pay approximately $154.70 monthly premiums. For such individuals, premiums increase as incomes increase. For example, individuals filing tax returns of over $160,000 may pay approximately $287.30 a month for Medicare Part B premiums.

For additional information regarding Part B premiums, seniors can call the Social Security Department at 1-800-772-1213 or visit the Social Security Web Site

Enrolling In Medicare B

Seniors who choose to wait for Part B coverage may have to pay higher premiums if they wait, so individuals are encouraged to seriously consider enrolling in Part B when they first become eligible for Medicare Services at age 65. Costs for Part B services may go up as much as 10% for each 12 month period that the senior could have selected Part B but didn't. This extra 10% premium will have to be paid for the duration of the Medicare Part B coverage.

Medicare Part B

Depending on geographical area, Medicare choices and options may vary. In some cases, individuals may enroll in services that offer Medicare Part A, B and D coverage at the same time, while others don't. Individuals may enroll or sign up for Medicare Part B coverage at any time during the seven months following the initial three-month sign up period when they turn 65.

Individuals can sign up for Medicare at their local Social Security office by filling out a form. Premiums for Part B are generally taken out of monthly Social Security checks, Railroad Retirement Benefits, and Civil Service Retirement benefits. If individuals are not covered under such benefit plans, Medicare bills for premiums in three-month increments.

Individuals are advised to contact the Social Security administration about three months before their 65th birthday to sign up for Medicare, but seniors can sign up for Medicare benefits even if they don't plan to retire at age 65. The seven month initial enrollment period begins three months before the birthday month, includes the birthday month itself, and the three months following the birthday.

For individuals diagnosed with permanent kidney failure or disabilities, Medicare enrollment periods will depend on the date that treatment for or the disability begins.

Conclusion

Seniors are advised to access government web sites for up to date information such as the Social Security Administration, Medicare, and professional health care service providers such as the local Department of Health and Human Services to determine eligibility and advice regarding Medicare services in your county and state.

Medicare and Medicaid Page


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