Original Medicare includes two parts- Part A and Part B. Medicare Part B 2020 covers many essential and common medical services for you, and only those that are considered medically necessary at the time will be covered by it. Part B includes coverage for primarily outpatient services, as well as ambulance care and preventative care services. It can also include the cost of durable medical equipment. In some cases, it will cover home health and rehabilitation costs, but only from Medicare-approved facilities. It can cover you for physical therapy as well, so long as a doctor has ordered that kind of service for the treatment of your medical condition.
A lot of these services and whether or not they are covered under Part B will be dependent on whether they were doctor ordered and whether they have been deemed medically necessary in your situation. If you try to have some of these services provided to you when a doctor does not recommend them, then you may end up paying for them entirely on your own. You do have the legal right to know whether you will be covered by your plan for a medical service before that service is administered to you.
A Look at the Coverage
We have talked only briefly about what Medicare Part B will cover for you, so now let’s get into some more detail about its coverage and what it can do for you.
Part B often includes coverage for some initial “Welcome to Medicare” services. This can include flu shots, hepatitis B shots, a preventative care visit with a general practitioner, screenings for diabetes, cancer and heart health and more. You can refer to the handbook “Medicare and You” if you would look to see a full list of all of the preventative care services that are included in Part B’s coverage. This booklet is available through Medicare directly.
You will be covered for all Part B services if you have an Original Medicare plan. This would also include cover for Medicare Part A, and it is available to most seniors when they turn 65. In many cases, you will be automatically signed up for this plan once you reach the eligible age. You can also get this kind of coverage if you sign up for a Medicare Advantage plan, which will include coverage for Part A (except for hospice care), Part B, emergency services and urgently needed care, among some other things.
How Do You Achieve Part B Eligibility?
Are you wondering what it takes to qualify for Medicare Part B? Let’s look at the minimal requirements for this coverage plan.
First of all, you must be 65 years or older. There will be exceptions to this made due to certain medical conditions, so you can check with us or with a Medicare agent if you are unsure if you qualify.
The other requirement is that you be a US citizen. Anyone who has been a permanent resident for five consecutive years or more will also qualify. With both of these requirements, if you do not qualify just yet, you will generally qualify if you simply wait a bit longer.
Some people qualify for Medicare Part B 2020 because of a disability. In most cases, you will be enrolled automatically into Part B once you have been on disability and been receiving benefits for a minimum of 24 months. Those with end-stage renal disease will qualify for Medicare Part B before they reach age 65 as well. Other conditions, such as amyotrophic lateral sclerosis, may qualify for early eligibility as well. Once again, talk to our healthcare insurance team or a Medicare agent to find out if you qualify for early eligibility in your situation.
The Cost of Part B
Medicare Part B comes with a monthly premium and an annual deductible. The premium will cost $135.50 a month for the lower income bracket. Anyone who makes less than $85,000 a year will only pay this amount per month, which is the vast majority of Americans. The rates can go as high as $460.50 per month, depending on what your income level is. You can check Medicare’s website for full rates, and you should be aware that these are standard rates for Part B that are set by Medicare itself.
Since Part B only comes through Medicare or through an Advantage plan provider that uses the same Medicare plan, the rates are set by Medicare and are not going to change dramatically and unexpectedly. Medicare will notify Part B subscribers before any rate changes take place.
If you are having trouble paying the annual deductible and other costs related to Part B, you can sign up for a Medicare Supplement plan to cover these costs.
The Enrollment Period for Part B
You can sign up for Part B during its enrollment window. This occurs at age 65 in most cases, and if you are getting retirement benefits before age 65, then you will be automatically enrolled in Part B.
If you miss the enrollment window for Part B, then you can get this plan during what is called the General Enrollment period. This starts on January 1st and will run until March 31st. The coverage, once approved, will begin to cover you on July 1st of that same year. If you did not sign up when you first became eligible for the plan, then you may be required to pay a late fee.
The fee is generally calculated by adding 10% for each 12-month period in which you could have signed up for Part B after you became eligible but did not.
If you would like to know more about Medicare Part B 2020, then please give us a call. We will gladly answer all of your questions and help you figure out if Part B is something that you are eligible for and if it is right for you. You may also want to get in touch with a Medicare agent to learn more about this common healthcare plan that covers many essential medical services and expenses.
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