Medicare Part B helps pay for:
- Physician services (inpatient and outpatient)
- Durable medical equipment and supplies
- Home health care
- Diagnostic and lab tests
- “Welcome to Medicare” physical exam
- Diabetic screening, services and testing supplies
- Glaucoma testing
- Screening mammograms/Pap Tests
- Vaccinations (flu, pneumonia, hepatitis)
This is an incomplete list. To learn the details about Medicare Part B benefits, see Understanding Medicare or What Part B Covers
Medicare Part B Costs
It is important that you sign up for Medicare Part B when you are first eligible. Not enrolling in Medicare when you are eligible may result in financial penalties and time delay for enrollment.
The standard Part B premium is $135.50 per month in 2019 if your countable income is equal to or below $85,000 for an individual or $170,000 for a couple. Higher premiums are charged for incomes above these levels. The amount is determined by Social Security.
| If your yearly income on your 2017 tax return is | Income Related Monthly | Your Part B
Premium is |
|
| Individual Tax | Joint Tax | ||
| $85,000 or less | $170,000 or less | $0 | $135.50 |
| $85,001-107,000 | $170,001-214,000 | $54.10 | $189.60 |
| $107,001-133,500 | $214,001-267,000 | $135.40 | $270.90 |
| $133,501-160,000 | $267,001-320,000 | $216.70 | $352.20 |
| $160,000-$499.999 | $320,000-$750,000 | $297.90 | $433.40 |
| $500,000 or more | $750,000 or more | 325.00 | $460.50 |
**Exception: those eligible for paying under $135 due to Social Security “hold harmless” provision.
The Part B annual deductible for 2019 is $185 and there is a 20% copayment for Medicare approved charges and services. Medicare pays 80% of the Medicare-approved amount. If a provider accepts assignment he/she agrees to accept the Medicare approved amount for services provided. Providers who do not accept assignment may charge 15% above the Medicare approved amount. This is called the Limiting Charge.
Some Common Services Not Covered By Medicare
- Long term custodial care (nursing home)
- Private hospital room (medically necessary); Private duty nursing
- Ambulance Services (unless medically necessary)
- Routine physical care, other than the “Welcome to Medicare” exam
- Routine dental care and dentures; hearing exams and hearing aids
- Routine eye exams and eyeglasses (except cataract lenses)
- Routine podiatry care; Acupuncture, most Chiropractic Services
- Christian Science practitioners and Naturopath’s services
- Orthopedic shoes, unless part of a leg brace or nerve defects due to diabetes; Cosmetic Surgery
- Services provided outside the United States (with some exceptions)
