Medicare Part B

Original Medicare features Part A, which covers hospitalization costs, and Part B, which covers medical costs. Part B coverage is slightly more complex than Part A, as recipients are often required to pay premiums for this component of Original Medicare coverage. Here is what you need to know about Medicare Part B.

What Is Medicare Part B?

Medicare Part B covers medically necessary services and preventive services. Medically necessary services are defined as any services or supplies that are needed to diagnose or treat your medical condition, while preventive services are health care services that are used to prevent future illness. Most preventive services are offered at no cost if you find a healthcare provider who will accept the assignment. These are some examples of what Part B will cover.

Clinical Research

Clinical research studies are used to test the effectiveness of different types of medical care work. These tests are performed to ensure that the form of care is safe for patients. For example, a research study may be used to determine whether a specific cancer treatment drug works without causing undue harm to patients. A clinical study can involve diagnostic tests, surgical treatments, medicines, or alternative/new types of patient care. Suppose you are participating in a clinical research study. In that case, Medicare may cover a portion of the costs, though you may need to pay 20% depending on the treatment you get. Deductibles may apply.

Ambulance Services

If you are in a situation where normal forms of transportation could endanger your health, Medicare Part B will cover ground ambulance transportation to a hospital or skilled nursing facility. In certain situations, Medicare may pay for emergency ambulance transportation in an airplane or helicopter if you require rapid transportation that ground transportation cannot provide. Medicare may cover non-emergency ambulance transportation if you have a written note from your doctor stating that it is medically necessary.

Durable Medical Equipment

If your doctor prescribes medically necessary durable medical equipment, Medicare Part B will cover the cost of purchasing them. Some examples of durable medical equipment include the following:

  • Walkers
  • Wheelchairs
  • Scooters
  • Chair lifts
  • Infusion pumps
  • Hospital beds
  • Crutches
  • Blood sugar monitors
  • Blood sugar test strips
  • Continuous positive airway pressure devices

Part B deductibles do apply to the purchase of durable medical equipment. You are responsible for paying 20% of the Medicare-approved amount of durable medical equipment costs accepted by a supplier.

Mental Health Care

Part B also covers mental health care services. Part A covers inpatient services, but Part B covers outpatient and partial hospitalization for mental health conditions. Part B will help pay for the following outpatient mental health services:

  • One yearly depression screening
  • Family counseling
  • Individual or group psychotherapy
  • Psychiatric evaluations
  • Medication management
  • Diagnostic tests
  • Partial hospitalization programs
Part B Costs

The standard premium for Part B coverage in 2021 is $148.50, but this premium will be higher if you fall into a higher income bracket. If you receive benefits from Social Security, the Railroad Retirement Board, or the Office of Personnel Management, your Medicare Part B premiums are automatically deducted from those payments. If you are not a recipient of these benefits, you will be billed directly. The Part B deductible is $203. After meeting that deductible, you will have to pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment. 

Contact Grutz Financial for any Medicare-related assistance you may need.

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