Medicare Part B
Medicare Part B covers medically-necessary services and some preventive services that aren’t covered by Medicare Part A. If you enroll in Part B, Medicare will pay 80% of the “reasonable charge” for covered services after you’ve met the deductible for that year. You are responsible for paying the other 20% (co-insurance).
Medicare has a defined “reasonable charge” for services that might be less than what the doctor charges. In that case, you’ll be responsible for paying 20% plus the difference between the actual cost of service and Medicare’s reimbursement. Some doctors may accept assignment, meaning they’ll only charge Medicare’s “reasonable charge” for services, forcing you to pay the 20% co- insurance.
You are responsible for paying the Part B premium each month. The standard premium is $96.40. You might have to pay a higher premium based on your income if you file single on your tax return and your modified adjusted gross income (MAGI) is higher than $85,000. For married filing jointly, the MAGI limit is $170,000. Individuals and couples who exceed the minimum income limits could pay as much as $308.30 a month.
If you receive Social Security or Retired Railroad Board (RRB) benefits, you’ll automatically receive Part B on the first day of the month you turn 65. Your Medicare card will come in the mail 3 months prior to turning 65. If you are under 65, you’ll receive Part B after you’ve received disability benefits from Social Security or RRB for 24 months. Your Medicare card will come in the mail on the 25th month of your disability.
Though you are automatically enrolled in Part B under the previously mentioned circumstances, you don’t have to keep it. If you don’t want Part B, your card will come with instructions on cancelling it. Follow those instructions and send the card back. If you keep the card, you will pay Medicare part B premiums. Premiums are automatically deducted from your Social Security or RRB benefits.
If you’d like to receive Part B, but you’re not receiving Social Security or RRB benefits, you can sign up during the initial enrollment period which starts 3 months before the month you turn 65 and ends 3 months after you turn 65. You can also sign up for Part B during the general enrollment period from January 1 to March 31 each year and your coverage will begin on July 1 of that year. Also, if you missed the signup during your initial enrollment period, you might face a 10% increase in your monthly premium.
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