Medicare Part B: What It Covers, What It Costs

Medicare Part B is outpatient coverage that helps pay for doctor visits and other medical services and supplies.

Medicare Part B, also known as Medicare Part A, is the Medicare portion that covers doctor visits and outpatient medical services. The average monthly premium for 2021 will be $148.50. The premium is adjusted every year and can change depending on your income.

Medicare Part B eligibility

You become eligible for Medicare Part B at age 65 and should sign up during the Initial Enrollment Period, the seven-month period around your birthday. It is crucial to meet the deadline. You could face a costly penalty if you miss the deadline.

What Medicare Part B covers, and what Medicare Part A doesn’t

It’s important to remember that Medicare, including Part B, won’t take care of all of your health care costs. There are copays, deductibles, and premiums. Some elements of long-term care may not be covered by Medicare. Phil Moeller, author “Get What’s Yours For Medicare: Maximize your Coverage, Minimize your Costs” says that even those who have the best retirement plans don’t always take into account health care costs, including Medicare costs.

Medicare Part B costs

Part B premiums

Your income can affect the premiums you pay.

The majority of Medicare Part B subscribers will pay $148.50 monthly premiums in 2021. (Premium amounts are adjusted every year.

Beneficiaries with high incomes may be eligible for higher payments. In addition to the Part B premium, beneficiaries whose income exceeds $88,000 may be subject to an income-related monthly adjustment, or IRMAA. The total premium payments for those whose income exceeds $88,000 can range from $207.90 up to $504.90 depending on their income. For a full list of adjusted premium costs, visit Medicare.gov.

Part B copays and deductibles

Medicare Part B has an annual deductible. It will be $203.

You typically pay 20% of Medicare-approved amounts for doctor services after you have met your deductible. This assumes that your doctor accepts Medicare assignment. Your provider will accept the Medicare-assigned amount for treatment or services. Patients may be charged by providers who charge more that the Medicare-assigned amount. Always verify with your new doctor or another health care provider that Medicare covers the difference.

Original Medicare enrollees often purchase Medicare Supplement Insurance (also known as Medigap) to cover the out-of pocket costs associated with Medicare Part B.

Penalty for Medicare Part B

It is crucial to sign up for Medicare Part B promptly. You’ll be charged an additional 10% if you delay signing up for Part B after you turn 65. You’ll also pay more for all of the time you are covered under Medicare. This premium can add up to a substantial amount in retirement.

You can choose Medicare Advantage

Many people who sign up for Medicare choose a Medicare Advantage plan, also known as Medicare Part C.

Medicare-approved private insurers administer Medicare Advantage plans. These policies must offer the same coverage as Original Medicare Part A or Part B. These policies often include Medicare Part D prescription drug coverage, as well as additional benefits not covered under Original Medicare such as vision, dental, and home-care benefits.

Medicare Advantage plans often work with a network provider network to provide these additional benefits and lower costs. This is in contrast to Original Medicare, where beneficiaries can receive care from any Medicare provider.

It is important to compare the total cost of Medicare Advantage versus Original Medicare. You should be aware that the cost sharing and benefits of the plan can change year to year. Therefore, you will need to review coverage every Medicare open enrollment period. Medicare.gov offers a tool to help compare Medicare Advantage Plans.

Remember: If you select Medicare Advantage and then choose to go back to Original Medicare with Medicare Supplement Insurance you might pay more than you anticipated. In all other states, you can be denied coverage if you do not sign up for a Medigap plan within six months from the date your Original Part B Medicare insurance starts.