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What Is Medicare Part B

Medicare Part B is outpatient medical coverage for stays at any hospital or medical facility for less than 24 hours (even if your stay occurs overnight). It is part of Original Medicare and covers medically necessary services and supplies.

Medicare Part B
Coverage & Cost

Medicare Part B coverage includes outpatient preventive services such as your annual flu shot and annual wellness visit to prevent illness. It also covers medical screening tests such as cardiovascular disease and colorectal cancer screenings to detect health conditions early so treatment is most effective.

Furthermore, Part B covers ambulance services and durable medical equipment. Before Medicare Part B will cover your medical service or equipment, you first must pay $203 annual deductible for 2021.

Medicare Supplement plan

Before Medicare Part B will cover your medical service or equipment, you first must pay $203 annual deductible for 2021.

Diabetes Screening And Supplies

According to the National Diabetes Statistic Report 2020, Diabetes affected 34.2 million Americans in 2018. In other words, 10.5% of the US population had diabetes. Moreover, 11.5 million seniors age 65 or older were diagnosed with diabetes.

Therefore, it is important you know whether you are one of those millions of people who have diabetes. You may be at high-risk for diabetes if you have any of the following:

Medicare Part B covers diabetes screening if your doctor determines you are at risk or diagnosed with pre-diabetes. Furthermore, you may be eligible for up to two screenings per year. After you are diagnosed with diabetes or prediabetes, Medicare Part B covers the following supplies:

Moreover, with Medicare national mail order program, you can have diabetic testing supplies mailed directly to your home. Most importantly, Medicare covers outpatient diabetic self-management training (DSMT) to help you learn how to better manage your diabetes. As a result, you can learn how to monitor your blood sugar, eat healthy, exercise, and manage your prescriptions. Medicare Part B costs for diabetes self-management training is 20% of the Medicare-approved amount and $203 deductible in 2021

Mobility Equipment

Healthday reports an estimated 8.5 million seniors use mobility devices. In particular, more than 16% of seniors use canes.

My father is a baby boomer and he loves to speed around the community in his electric golf cart. We live in Florida and I sometimes see people riding scooters on sidewalks and crossing intersections.

Mobility equipment can improve your quality of life by making it easier to get around. Furthermore, by learning how to operate mobility devices such as power wheelchairs and electric scooters, you can ride indoors and outdoors with independence and ease.

When you are speeding on your scooter, you may feel young again! Having the freedom to go where you want when you want gives you mobility independence. Whatever mobility equipment you use, it helps you get out in the world and connect with people, especially the ones you love.

To qualify for Medicare to pay for mobility device, you must have a disability which prevents you from doing the following activities: bathing, toileting, personal care, feeding, and dressing.

If your doctor or healthcare professional certifies you can not perform the activities listed above, then Medicare may pay 80% for you mobility device. Therefore, with Medicare Part B the cost you pay is 20% of the Medicare-approved amount and the $203 deductible for 2021.

Medicare Part B – Preventive Screening Costs

You pay nothing for these preventive screening tests if your doctor or other qualified health care provider accepts assignment. In other words, these services are free to you when your doctor or provider agrees to be paid directly by Medicare and to accept the Medicare-approved payment amount. Therefore, for free services you will not be billed any more than Medicare Part B deductible cost of $203 in 2021. The table below show you the cost of preventive screening services covered by Medicare Part B:

Medicare Part B Preventive Screening Costs chart

Counseling and Training Costs

Medicare may only cover your counseling sessions if they are provided by a doctor and take place in a primary care doctor’s office or primary care clinic. However, a registered dietitian or nutritional professional can provide medical nutrition therapy (MNT) services if you have diabetes or kidney disease. In addition, you can get MNT if you have had a kidney transplant in the last 36 months. Best of all, you can get no-cost counseling with Medicare Part B.

Medicare may cover up to 10 hours of initial diabetes self-management training (DSMT). You get 1 hour of individual training and 9 hours of group training. In addition, you may qualify for up to 2 hours of follow-up training each year. To get DSMT, you pay 20% of the Medicare-approved cost and Part B deductible of $203 in 2021.

  • Biopsy Costs
  • Hepatitis
  • Prostate Cancer Screening Costs
  • Telehealth Costs

Biopsy occurs when a screening discovers the presence of abnormal tissue and the doctor removes a sample for later examination. For example, if a colonoscopy discovers a polyp and the doctor removes it, you pay 20% of Medicare approved amount for your doctor’s service.

Hepatitis is a medical condition defined by inflammation of the liver and characterized by the presence of inflammation cells in the organ tissue. You need to know hepatitis may occur with few or no symptoms. So it is important you get screened especially if you are at high risk because hepatitis can lead to jaundice, nausea, and in rare cases death. In addition, some forms of hepatitis may cause cirrhosis and liver cancer.

The good news is hepatitis B shots may cost you nothing if you have any of the following medical conditions:

  • Hemophilia
  • End-Stage Renal Disease (ESRD)
  • Diabetes
  • Live with someone who has hepatitis B
  • You are a health care worker and have frequent contact with blood or bodily fluids

Medicare Part B covers prostate cancer screening every 12 months for men over the age of 50, including digital rectal exams and prostate antigen (PSA) blood tests. To get a digital rectal exam, you pay 20% of the Medicare-approved costs and Part B $203 deductible in 2021. However, you pay nothing for the PSA blood test.

Medicare Part B covers certain telehealth medical services with healthcare professionals using real-time video or phone communication. You are responsible for paying the 20% coinsurance and the Part B deductible.

Medicare Part B can provide you with the following counseling telehealth benefits:

  • Alcohol misuse counseling
  • Cardiovascular behavioral therapy
  • Diabetes self-management training
  • Medical nutrition therapy
  • Obesity counseling
  • Psychotherapy
  • STI counseling
  • Tobacco cessation counseling

How Do I Enroll In Medicare Part B?

You may automatically be enrolled in Medicare Part B if you receive Social Security income benefits. Consequently, you may receive your Medicare card 2 to 3 months before you turn 65. Otherwise, you can enroll in Medicare Part B in the following three ways:

  • Go online at www.ssa.gov
  • Call 1-800-772-1213
  • Visit your local social security office and register in person
Medicare Part B

What Is Medicare Part B Late Enrollment Penalty?

It is important you enroll in Part B during your initial enrollment period unless you have creditable coverage such as employer group coverage. Otherwise, you will be subject to a penalty! This penalty is equal to 10% per year for every year (12 full months) that you wait to enroll. The late penalty is added to your Part B premium for as long as you have Part B.

However, it gets worse because you may need to wait for the Medicare General Enrollment Period to enroll in Part B. This period runs from January 1st to March 31st each year. When you enroll during this period (and its after your initial enrollment period ) your benefits will begin July 1st. This can be a double whammy because you may owe late enrollment penalties and have to wait months for your coverage to start.

What Does Medicare Part B Cost In 2021?

In 2020, Part B deductible costs $198. However, in 2021 this cost increased to $203. After you pay the deductible, you may owe 20% coinsurance on Medicare-approved amounts. Your coinsurance costs can add up to thousands of dollars especially for outpatient surgeries or chemotherapy. Moreover, there is no limit or cap on your 20% coinsurance cost. Therefore, your costs can add up to tens of thousands of dollars or more!

You can avoid unlimited coinsurance expenses by getting a Medicare supplemental plan. Then you will have a fixed healthcare cost no matter how often you need medical services.

Medicare Part B Premiums 2021

What Is Not Covered By Part B?

Medicare Part B does not cover inpatient hospital services and prescription drug coverage. Learn more about the Medicare Parts that cover these benefits.

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