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What is Medicare Part B?

With all of the alphabet soup of Medicare, the details of the plans can get a little confusing. Not to worry, I am here to help. So let’s focus on Medicare Part B for a minute.

Medicare Part B is going to be the coverage you will need in order to have any doctor visit, outpatient surgeries, durable medical equipment, chemotherapy treatments, physical therapy visits, etc. covered. In my opinion, Medicare Part B is essential. This is what is going to cover more routine medical needs. Where Part A covers inpatient hospital stays, Part B is going to pretty much cover everything else.

Because we are more likely to see a doctor for a routine check up or for the flu, Medicare Part B is going to come in handy for these types of visits.

When you use Medicare Part B, there is an annual deductible. For the year 2018, the deductible is $183. The deductible will reset January 1 of each year. Medicare determines the deductible amount every year. That just means that the deductible is subject to change.

Once you have met your deductible, you then participate in an 80%/20% cost share with Medicare. This means Medicare will pay about 80% of your doctor bills and you will be responsible for the remaining approximate 20%.

One thing to take note of is Medicare does not put a maximum annual out of pocket limit in the benefit. This means that each time you go to the doctor, you will pay your roughly 20% in every situation. Unfortunately, if you have a rough year, you will always pay your portion of the cost sharing. There is no cap to the amount of money you would spend on Medicare by itself.

Medicare Part B does bear a monthly premium. The monthly premium is based on your income. Because a person can put off doing their tax return, Social Security and Medicare are going to use your income from two years ago to determine your Medicare Part B premiums.

That may sound a little confusing so let me break it down a little bit.

If you are going on Medicare in the year 2018, Medicare and Social Security are going to use your income reported from the year 2016 to determine your monthly premium.

There is a chart available on that will tell you where you will fall on the Medicare premium scale.

Here is a link to that table:

In a nutshell, if you are a high income earner, you will pay more for your Medicare Part B then someone who is a “average income earner”.

On the other end of the spectrum, if your income is below a certain level, you may qualify for state sponsored assistance in paying your Medicare Part B premium. In a lot of states, this is called Medicaid. The best way to find out if you qualify for state sponsored Assistance is to call your local department of health and human services.

When it comes to adding additional insurance to Medicare, you are required to have both Medicare Part A and Medicare Part B.

One exception to this rule is if you are actively employed. Your employer coverage does not generally require you to be on Medicare. However, if you’re working for an employer with under 20 employees, it is likely you might be required to go on to Medicare when you turn 65.


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