Part B covers outpatient medical services and procedures. This includes medically necessary services to diagnose and treat conditions, as well as some preventive services.
What does Medicare Part B cover?
- Provider services: This includes any treatment that is considered medically necessary.
- Durable medical equipment (DME): This type of equipment must serve a medical purpose, must be able to be used at home, and can be used repeatedly.
- Examples include blood sugar test strips, crutches, and hospital beds.)
- Home health services: This includes care provided in a beneficiary’s home
- Ambulance services: This covers any ambulance transportation in emergencies. Some coverage is provided for non-emergent care if there is no alternative transportation.
- Preventive services: This includes physical, speech, and occupational therapy.
- Lab and radiology tests: All tests are covered as long as they are ordered by a provider.
- Chiropractic services: Coverage provided if medically necessary to fix spine subluxation.
- Prescription drugs: Common drugs are covered under a separate policy, but Part B provides coverage for some drugs such as cancer medications, immunosuppressants, dialysis medications, and antiemetic drugs.
How much does Medicare Part B cost?
Unlike Part A, Medicare Part B does have a monthly premium. The government sets this premium, and it changes each year. Your income level can also impact your premium.
Do I have to apply for Medicare Part B?
Individuals already collecting retirement benefits from the Social Security Administration or the Railroad Retirement Board will automatically be enrolled in Medicare Part B. Your Medicare card will arrive in the mail the month prior to your 65th birthday.
Individuals who are not already receiving retirement benefits will need to apply for Medicare Part A. This can be done at a local social security office, online, or by phone.
Medicare Part B Excess Charges
Without a Medicare Advantage or Medigap plan, all Medicare beneficiaries will pay for the 20% of expenses that Original Medicare does not cover. Providers who do not accept Medicare assignments are allowed to charge up to 15% more for services. These are known as Part B excess charges.
If an individual has a Medicare Advantage or Medigap plan, these excess charges are usually covered under those plans, as well as the 20% not covered by Parts A and B.