Medicare Part B is one of two parts of Medicare. It’s sometimes called “Medicare Plus” or “Medigap.” The other part is Medicare Part A, which provides basic hospital coverage. The government administers both parts; you don’t have to enroll in one or the other, but you can’t have one without the other (unless you’re under 65 and qualify for Medicaid).
Medicare Part B Coverage for Office Visits
If you have Medicare Part B, you’ll pay 20 percent of your office visit charges after an annual deductible. As long as your doctor accepts Medicare assignment, they must accept the terms outlined by Medicare. They cannot charge any more than what your plan pays them.
Medicare Part B Coverage for Durable Medical Equipment
The Medicare Part B plan covers durable medical equipment such as wheelchairs, walkers, and other mobility devices. The program will also cover prosthetic limbs if needed due to an amputation or a partial loss of use of one or both legs. Other durable medical equipment that may be covered include hearing aids and diabetic supplies like blood glucose monitors and insulin pumps.
Medicare Part B Coverage for Cancer Treatments
Medicare Part B also offers coverage for many cancer treatments, including chemotherapy drugs and other medications related to cancer treatment, such as immunosuppressants and antineoplastics. In some cases, Medicare will also offer coverage for radiation oncology treatments like radiation therapy or brachytherapy.
What Does Medicare Part B Not Cover?
Medicare Part B doesn’t cover everything. It doesn’t cover:
- Durable medical equipment (e.g., wheelchairs, walkers, or oxygen)
- Laboratory tests (other than those ordered by a doctor) or radiology services (e.g., x-rays)
- Private duty nursing or personal care in a nursing home or hospital
- Hearing aids, eyeglasses, and dental services unless they’re medically necessary to treat an illness or injury that’s covered under Part A; nor does it cover routine dental checkups, routine foot care, or routine eye exams for healthy people over 65 (although it does cover emergency treatment for serious dental problems).
How Much Does Medicare Part B Cost?
The monthly premium for 2022 is $170.10. There are income guidelines that can increase the premium you are responsible for. Your premium is determined based on your Modified Adjusted Gross Income (MAGI) in the previous two years.
Medicare Part B Eligibility and Enrollment
You can enroll in Medicare Part B any time during the year except during the annual enrollment period from December 7 through January 31. You will get your first bill for Medicare Part B after enrolling, but you will have 90 days from your eligibility date to make your first premium payment without late penalties. If you do not pay your premium for either Part A or Part B within 90 days of your eligibility date, you will be subject to late penalties on all future bills.
How Do Private Medicare Insurance Plans Enhance Part B
Medicare Advantage – Part C
Medicare Advantage plans are private health plans that offer Medicare benefits to beneficiaries.
Medicare Advantage plans can offer additional benefits such as vision, hearing, dental, and prescription drug coverage. This allows your health plan to coordinate all your health care needs in one place.
These plans allow you to choose your own doctors and other providers. Still, you may pay more out-of-pocket than other types of Medicare Advantage plans because they don’t have networks of providers who agree to accept reduced fees from Medicare. In addition, some private fee-for-service plans require you to receive all your care through certain doctors or hospitals, making it impossible to see other doctors without paying additional coinsurance or co-payments on top of what Medicare normally charges for those services.
Medicare Supplement Insurance – Medigap
Medicare Supplement Insurance, also known as Medigap, is a type of private insurance that helps pay for some of the costs not covered by Original Medicare.
Standalone Prescription Drug Plans – Part D
Standalone prescription drug plans are private plans that usually have lower monthly premiums than other Medicare Supplement options. Medicare Part D only cover prescription drugs, so they might not be the best choice if you have additional health care needs.