When referring to base level Medicare coverage, what’s often included are actually two separate parts. While Part A addresses hospital issues and home care, Part B can help out with the costs associated with more routine medical care. Individuals are often times automatically enrolled in both parts of Medicare upon their 65th birthday, however, some can specifically opt out of Part B if they have coverage through a spouse or employer.
Part B plans typically involve a monthly premium that is calculated based on your income. It’s the goal of Medicare to make their coverage affordable, and in some instances, Part B can be obtained for less than $150 per month. Even if you do not qualify for premium-free Part A, you may still be eligible for Part B benefits.
The Basics Of Part B
If you have a health condition that requires ongoing treatment by your primary care physician, Part B may help to cover a variety of the associated costs. A one-time “Welcome to Medicare” preventative visit is included free of charge, and various services and supplies may come at low or no cost depending on your specific needs.
Outpatient care, preventative services, durable medical equipment, and more are often also included under this plan. Some individuals receive the same benefits included in Part B through a Medicare Advantage plan, and these plans aim to offer equal, if not greater, levels of benefits.
Keep in mind that there are enrollment conditions when it comes to Medicare Part B, and if you are not automatically enrolled due to a disability or when turning 65, you may be subject to a penalty. Individuals who choose to skip Part B coverage because they have health insurance through an employer should pay special attention to these time frames. If and when their coverage ends, they have a specific window in which they can sign up for Part B without paying any additional fees.
While it is nice to be able to rely on a fixed set of bills year after year during retirement, enrollees should remember that the premiums for Medicare Part B can change annually. For most, their premium is automatically deducted from their Social Security benefits. If not, individuals will be sent a bill every three months.
Initial enrollment in Part B also begins a six-month window for a Medigap Open Enrollment Period, where individuals can select additional plans to supplement their existing coverage. While these plans may be added at a later time, this open enrollment offers a guaranteed-issue right regardless of any pre-existing health conditions.
Deductibles associated with Part B plans are also subject to change each year but are typically only several hundred dollars. Individuals are also usually responsible for paying 20% coinsurance on covered services, meaning that even if you visit a Medicare provider for routine care you will likely incur out of pocket expenses.