Medicare Part B
Medicare Part B is medical insurance.
It helps pay for some (but not all) medically necessary doctor’s services (inpatient and outpatient), durable medical equipment, physical and occupational therapy, home health care, ambulance services, and preventative services.
Enrollment is optional and there is a premium. You can enroll in Part B anytime during your Initial Enrollment Period. Your Initial Enrollment Period begins three (3) months before the month you turn age 65, and ends three (3) months after the month you turn age 65.
The premium is based upon your income. For new Medicare enrollees in 2011, if your individual income is less than $80,000, or combined is less than $170,000, your premium will be $115.40. If you are enrolled in Medicare Part B prior to January 1, 2011, there will be no change in your current premium.
Medicare Part B has an annual deductible, which is $162, in 2011. After you have met the deductible, Medicare pays 80% of eligible covered charges and 100% of Medicare-covered lab services, which covers things like blood tests for diagnostic services.
Eligible charges are defined as the amount of a covered service approved by Medicare (i.e. If your doctor charges you $100 for a service, and Medicare approves $80, assuming you had already met the deductible, Medicare would pay 80% of the $80, or $64. You are responsible for the remaining $16. If your doctor does not accept Medicare’s “assigned” charges, you might have to pay the excess amounts above what Medicare approved).
Medicare pays for a “Welcome To Medicare Physical”, which may be done in the first 12 months of becoming eligible for Medicare Part B. Beginning on January 1, 2011, Medicare beneficiaries will also be able to get an “annual” physical, which Medicare will cover at 100%*. However, you may not get the “annual” physical within 12 months of your “Welcome to Medicare Physical.”
*Most physical exams are covered at 100%. However, there are some things that the recipient might have to pay 20%.
For more information on the “Welcome To Medicare Physical” and the “Annual Physical Exam”, click on this link: Medicare Preventative Benefits.
