Home » What does Medicare Part B Cover? What is Part B Medicare?

What does Medicare Part B Cover? What is Part B Medicare?

The social security of every citizen of the country has been and remains one of the priority tasks of domestic social policy in the United States and related social programs. In particular, thanks to this approach of the government to solving social problems, the Medicare civil health insurance program was created in due time. Today the original Medicare program is the leader in demand among other health insurance programs in the country.

Medicare is a comprehensive federal health insurance program whose main subscribers, among other segments of the population, are people who reached age 65, as well as all clients who may receive certain retirement benefits and payments. The Medicare program has a complex structure and consists of several parts (Original Medicare and additional Medicare options), which correspond to different insurance plans for the different current medical needs of clients and patients.

To speak about the structure, Medicare has four parts that cover different health care segments, from hospital admissions to prescription drugs and payments. Basically, the types of plans by Medicare are Part A, Part B, Part C, Part D and the Medigap as an additional option. Each part of the Medicare insurance plan works in its own segment and the Medigap works as the supplemental part. Medicare Part A and Medical Part B form the so-called Original Medicare segment. In this article, you will learn more about Medicare Part B and the distinguishing features of this insurance plan.

Medicare Part B Coverage Key Features

Unlike other Medicare plans from the Original Medicare, which are most often focused on covering a patient’s hospital stay or for example, covering the purchase of essential prescriptions, Medicare Part B is primarily focused on covering medical outpatient services. Basically, those are the services which are determined medically necessary if it’s needed to effectively diagnose or treat a health condition, under the Medicare Part B coverage.

In other words, Medicare Part B helps pay for doctor consulting and other professional services, outpatient care, home health care services, durable medical equipment, and some preventive care services for the patients who reached age 65 and more. At the same time, the list of items covered by Medicare Part B may also include a rather wide range of various tests and laboratory screenings, such as cancer, diabetes and psychological disabilities testing.

The list of popular original insurance cases, which are covered by the Medicare Part B, include occupational and physical therapy, chemotherapy, emergency ambulance transportation and room care, echocardiograms performing, kidney dialysis and even some types of transplants. Along with this, Medicare Part B may also cover the use of medical equipment, such as wheelchairs, special walkers, stimulators and oxygen supplement equipment, for the patients who reached age 65 and more, and get Original Medicare insurance.

Medicare Part B Enrollment and Audience

Certain features of the enrollment and functioning of Medicare Part B should be clarified during the subscription process with an insurance specialist, but in general, Part B applies to quite specific segments of Original Medicare users. So, people who are eligible for free Medicare hospital support according to Medicare Part A can get Medicare Part B health assistance after they pay a monthly premium.

At the same time, those people who are not eligible for free Medicare Part A insurance, can only pay for the Medicare Part B insurance plan enrollment. The requirements for Part B enrollment are traditional and need age 65 or more, an American permanent residency or being a resident of one of the states during the recent five years before the current Medicare Part B enrollment period.

Mentioned previously monthly premium payment for Medicare insurance services is an automatically enrolled fee, which is paid each month for Medicare Part B coverage. The flat fee for the standard Original Medicare Part B monthly premium in 2021 costs $148.50. It is worth mentioning in addition, that people with higher yearly incomes may have to pay higher monthly Medicare premiums. In such a case, a yearly income of the Medicare Part B insurance subscriber is determined based on the tax return from two years ago.

Along with this, there’s also a so-called late enrollment penalty that can affect the Medicare Part B monthly premium. Such a penalty should be obligatory paid pay if the Medicare insurance subscriber didn’t enroll in Original Medicare Part B when was first eligible. In some cases, an enrollment penalty can increase the total enrollment payments for the Medicare Part B up to 10% of the standard fee for the year enrollment period.

The cooperation of an eligible Part B patient with Medicare may in some cases involve automatic enrollment. However, this option only works for some special segments of people, while most patients must subscribe to the traditional Original Medicare insurance subscription. So, people who reach age 65 and get retirement benefits from the Social Security Administration (SSA) or the Railroad Retirement Board (RRB), as well as amyotrophic lateral sclerosis (ALS) diagnosed patients, are automatically enrolled in Original Medicare.

Services Which are Not Covered by Medicare Part B

It was already mentioned that Medicare Part B provides insurance coverage for a wide range of medical cases and services, which were listed above. However, there are cases that cannot be covered by Original Medicare Part B insurance. So, the list of such exceptions from the coverage include cosmetic surgeries, dental, hearing and vision care, alternative health care services and long-term medical care. Part B coverage does not include prescription drugs and medical supplements, related to vision care, such as lenses, glasses, etc.

As far as Medicare Part B coverage does not include prolonged hospital medical services, for special cases that involve a long-term stay of the patient in a medical facility and subsequent support from specialists, it is strongly recommended to reconsider the insurance offers of each Medicare part and choose the appropriate one. It is always a good idea to consider all the current circumstances of the health care case and use the needed Medicare coverage part.