10 Things You Should Know About Medicare Part B

1. Medicare Part B is one of the two components of Medicare that is covered 100% of the time, no matter whether you have government-sponsored Original Medicare or a Medicare Advantage Plan operated by a private business. If you do not have Original Medicare, then your private insurance alternative is required by law to provide at least as much coverage as Original Medicare would under Part B. Your private firm may, at its discretion, offer an additional level of coverage for procedures Medicare does not insure.

2. When you enroll in Medicare Part B, you will be expected to begin paying a monthly premium for your Part B services. You will still be expected to pay this premium even if you do not require any Medicare Part B services for some time. The premium should be understood separately from the deductible, which is the amount you pay under Medicare Part A coverage before your full benefits will "kick in." A monthly premium is similar to other kinds of insurance premiums, which you pay every month regardless of use.

3. Your Medicare premium is generally very low, and will take into account your income level. According to current rules, less than five percent of Medicare beneficiaries will find their income is high enough to pay an expanded premium. Those who are expected to pay an additional premium amount will be contacted directly by Medicare. Generally, only people with a household income in excess of $170,000 will have to be concerned about paying a higher premium. All others will pay at the standard rate.

4. Medicare Part B is termed "medical insurance" and covers services and supplies as well as some preventative services. If you need home medical equipment such as oxygen or require a prosthetic limb or mobility device, all of these items will fall under your Medicare Part B coverage. Another way to understand Medicare Part B insurance is as "outpatient" insurance. Procedures that do not require you to visit or stay at a hospital are generally within the realm of Medicare Part B.

5. Medicare Part B is usually seen as a "bundle" with Medicare Part A. In just about every case, you will become eligible to receive Medicare Part B and Medicare Part A at the same time, beginning when you turn sixty-five. Although you will still be eligible, you will have to sign up for Medicare Part A and Medicare Part B manually if you are not yet receiving Social Security retirement benefits because you are still working. Whether you have filed for Social Security or not, you can receive Medicare Part A if you have paid Medicare taxes for ten years. You may be eligible for Part B separately from Part A if you are a U.S. citizen or legal permanent resident who has been in the country for five consecutive years.

6. When you enroll into government-backed Original Medicare, you will almost always have access to Medicare Part A and Medicare Part B. If you leave Original Medicare in favor of a Medicare Advantage Plan, your Advantage Plan is required to cover all of the same items that Original Medicare would cover. People may choose Advantage Plans in order to get additional coverage they would not be eligible for under Original Medicare.

7. Medicare Part B may require additional paperwork to meet some of your needs. For example, you may need a "Certificate of Medical Necessity" to receive services including home oxygen equipment. Your doctor or healthcare facility will have this paperwork on file. You should keep an eye on your Medicare Summary Notice and stay in contact with your healthcare facility to make sure everything you need is sent to Medicare.

8. Medicare Part B is notorious for limited coverage in some areas of healthcare. These include vision and hearing, for example. If you want routine eye exams and other eye care services to be covered under your plan, you should consider buying supplemental medical insurance. Your options for supplemental insurance include a variety of Medigap plans that can be combined with Original Medicare, or the supplements offered by private Medicare Advantage Plans. You are not eligible for Medigap under an Advantage Plan.

9. There is a large variety of screenings and preventative measures that Medicare Part B can cover. These include bone mass measurements, cardiovascular screenings, colon cancer, depression, diabetes, EKG, and many others. The majority of these are covered once a year. Some are seasonal, such as flu shots. Others, in very rare cases, may be covered only once during your lifetime. You may be surprised to learn that Medicare Part B will also cover a limited amount of counseling for weight loss and other issues.

10. It can be challenging to get certain kinds of services covered under Medicare Part B. This is especially true of "Durable Medical Equipment" -- including anything you use over and over, like mobility aids. To make sure that your claim for these items is accepted, get a prescription from a physician. A specialist who focuses on your problem may be more expensive to visit, but his or her word tends to be more convincing.