Medicare Insurance allows those who are 65 and over to pay for medical services that may not otherwise be available to us. Split into four parts, there are specific services that are covered by each section.
Part A: Covers inpatient hospital stays, skilled nursing, hospice care, and home health care.
Part B: Covers most doctor services, outpatient therapies, physical therapy, preventive care, and durable medical equipment.
Part C: Also known as the Medicare Advantage Plan, is a combination of Parts A and B while covering additional benefits not offered by Original Medicare (Parts A and B).
Part D: Medicare prescription drug coverage.
Let’s take a closer look at what Part B offers.
Medicare Part B Features, Costs
This is the part of Medicare that we think of most when it comes to health care insurance plans. Part B coverage offers medically necessary doctor’s services, outpatient care, and most other services that Part A does not cover. These may include physical or occupational therapies and some home health care services.
Part B also covers some preventive services. Though many services and products are covered, keep in mind that Part B is still not a complete medical insurance coverage plan. Original Medicare (Part A and Part B) covers many health care services and supplies. However, there are many costs or “gaps” it doesn’t cover.
Most people have to pay a premium for Part B. You can check to see if you qualify to receive help from your state to pay for premiums and deductibles. If you don’t qualify for this, then the premiums are usually deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. There are other payment options for premiums, such as quarterly bills or check drafts.
You have a seven-month window when enrolling in Medicare Part B, centered around your 65th birthday. Medicare gives such a wide window to enroll to give people time to learn about Medicare, talk to an agent, and decide on a plan. This period encompasses the three months before your birthday month, the birthday month, and three months after.
The best time to apply for Medicare or sign up for Part B is the three month window before the month of your birthday unless you are continuing to work or have employer coverage past 65. You can defer those payments until you are no longer working, too. If you miss that seven-month window, you may need to wait until the general enrollment period, January 1 to March 31 for a coverage effective date of July 1.
It’s important to note that what you pay can vary from year to year. The premium is based on income from the prior two years. So the costs could go up or down based on that. For example, if you sell property this year, your premium will go up in two years.
What are covered services under Part B?
Generally speaking – medically necessary physician and specialist service and the equipment they need to care for you. Other benefits include outpatient care and durable medical equipment, preventative services and screenings, physical therapy, and physician-administered medicine.
Also known as Part B drugs, this drug plan includes some chemotherapy drugs, cortisone shots for arthritis, and other medicine of that nature. Part B will not cover optional or elective services, such as hearing aids, glasses, alternative health care, routine chiropractic or massage therapies, prescription drug coverages, or custodial care.
However, Medicare will recognize eye diseases, such as cataracts disease, and will cover costs associated with those treatments.
What costs are you responsible for?
Part B has a Deductible and cost-sharing platform. There is an annual deductible to pay before Medicare comes into play. Once the deductible has been paid, Part B then covers 80 percent of the services or procedures. This means the patient will need to pay 20 percent of the services out of pocket.
However, that 20 percent could end up being quite costly. If you have concerns about possible medical conditions that could still end up costing thousands of dollars, contact VibrantUSA. We are independent insurance agents that have been specializing in Medicare since 2003.
Independent Insurance Agency Benefits
What are the advantages of working with an independent agent for Medicare health insurance? We are able to access more than 50 plans through more than 30 carriers throughout the region. We are not tied to any one carrier, meaning we can find the most affordable plans that cover your needs.
The best part? You don’t pay us anything for our services, so there are no additional fees for you to worry about. VibrantUSA is paid by the insurance carrier, not our client, allowing us to concentrate solely on you. Have questions about qualifying for Medicare, upcoming enrollment periods, or what to do if you’re turning 65? Contact VibrantUSA today.