The best place to start learning about Medicare is with the basics – with Parts A, B, C and D. The second in a four-part series, this “Medicare Basics” article will focus on Medicare Part B.
Medicare Part B is one part of what is known as Original Medicare, which is administered by the federal government and also includes Medicare Part A. Part B covers your doctor visits, most doctor services you receive as a hospital inpatient, most routine and emergency medical services, and some preventative care items.
What Medicare Part B Covers
Medicare Part B provides coverage for a variety of doctor and outpatient visits and services including routine doctor visits, some preventative items such as flu shots or screenings, diagnostic tests such as X-rays, emergency room services and more.
List of health items and services covered by Part B:
Doctor visits
Ambulatory surgery center services
Outpatient medical services
Some preventative care (like flu shots)
Some preventative health screenings (like a mammogram or colonoscopy)
Clinical laboratory services (like blood and urine tests)
X-rays, MRIs, CT Scans, EKGs and other diagnostic tests
Durable medical equipment (like wheelchairs, walkers and power scooters)
Emergency room services
Part-time, intermittent skilled nursing care and health aid services for the homebound
Mental health care when you’re an outpatient
You can always talk to your health care provider about what services you may need, or medical supplies, and whether Medicare will cover them. Sometimes, a service or item may be covered only under certain conditions.
Unlike Part A, which is premium-free for most people, everyone pays a monthly Part B premium. The standard Part B premium for 2021 is $148.50. However, your Part B premium cost will depend on your modified adjusted gross income as reported on your IRS tax return from 2 years prior (for 2021, use your income from 2019).
Depending on your income, your Part B premium could cost anywhere from $148.50 up to $504.90.
Part B also includes a deductible and copayments for most medical services, durable medical equipment and outpatient mental health care.
For 2021, the Part B deductible is $203.
For 2021, the Part B copayment for covered medical services, durable medical equipment and outpatient mental health care is20 percent of the Medicare-approved amount. (The amount a provider accepting Medicare assignment can be paid. You pay the remaining 80 percent.)
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