Medicare Part B
What is Medicare Part B?
Medicare Part B (Medical Insurance) helps cover your doctors’ services and outpatient hospital care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.
Most people will continue to pay the same premium they paid last year. The 2016 Medicare Premium for Part B is $121.80 per month. In some cases, this amount may be higher if you didn’t sign up for Part B when you first became eligible. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but didn’t sign up for it, except in special cases. You will have to pay this extra amount as long as you have Part B.
Medicare Part B Helps Cover Your Medically Necessary:
Medical and Other Services
Doctors’ services (not routine physical exams), outpatient medical and surgical services and supplies, diagnostic tests, ambulatory surgery center facility fees for approved procedures, and durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers). Also covers second surgical opinions, outpatient mental health care, and outpatient occupational and physical therapy including speech-language therapy. (These services are also covered for long-term nursing home residents).
Clinical Laboratory Services
Blood tests, urinalysis, some screening tests, and more.
Home Health Care
Part-time or intermittent skilled nursing care and home health aide services, physical therapy, occupational therapy, speech-language therapy, medical social services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), medical supplies, and other services.
Outpatient Hospital Services
Hospital services and supplies received as an outpatient as part of a doctor’s care.
Pints of blood you get as an outpatient or as part of a Part B covered service.
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Medicare Part B (2016)
Part B is Medical Insurance and covers physicians services, outpatient care, test, and supplies. (see Medicare Part B)
You Pay $166 Annual Part B Deductible THEN
Physicians services, inpatient, outpatient medical/surgical services, physical/speech therapy, diagnostic test.
|80% of approved amount||20% of approved amount|
|Clinical Laboratory Services
Blood Test, Urinalysis
|Generally 100% of approved amount||Nothing for Services|
|Home Health Care
Part-time or intermittent skilled care, home health aide services, durable medical supplies and other services.
|100% of approved amount; 80% of approved amount for durable medical equipment||Nothing for Services; 20% of approved amount for durable medical equipment|
|Outpatient Hospital Treatment
Services for the diagnosis or treatment of an illness or injury
|Medicare payment to hospital based on hospital cost||20% of Billed Amount|
|Blood||After first 3 pints of blood, 80% of approved amount||First 3 pints plus 20% of approved amount for additional pints|
|On all Medicare-covered expenses, a doctor or other health care provider may agree to accept Medicare “assignment.” This means the patient will not be required to pay any expense in excess of Medicare’s “approved” charge. The patient pays only 20% of the “approved” charge not paid by Medicare.
Physicians who do not accept assignment of a Medicare claim are limited as to the amount they can charge for covered services.