tr?id=172765944024608&ev=PageView&noscript=1 Tapestry Insurance Group - Details of Medicare Part B
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Details of Medicare Part B

May 12th 2020

Sorting out Medicare Part B details can be frustrating. There are so many conditions to apply you may want to scream. We know. We've been there. So, here are a few basic things to remember:

  • Medicare Part B is a voluntary program, so you must sign up to receive it.
  • You will pay a monthly premium for Part B coverage and a 20% copay.
  • Part B covers outpatient services.

Now for the details. Part B services are divided into two categories:

  • Medical services that are needed to diagnose or treat a medical condition.
  • Health care services to prevent or detect an illness.

Part B also covers physician charges during a hospital stay that are not covered under Part A.

Non-Preventive or Diagnostic Services

Part B covers diagnostic tests and services. The list of covered services is extensive and may vary from state to state. The Medicare.gov website provides a partial list of covered services.

Diagnostic Services require a copay. The standard copay is 20% of the Medicare-negotiated price; however, the amount of copay depends on:

  • Whether the doctor accepts assignments
  • Where the test or service is performed
  • What other insurance coverage is available

You should always check with your healthcare provider and Medicare to determine the correct copay.

Preventive Services

Well-check visits and associated tests are considered preventive services. No copay is required for these services if the health care provider accepts Medicare payments or assignments. Check with your healthcare provider before receiving services.

Other Services

Part B also covers the following services which are outside of the primary coverage groups:

  • Clinical Research Participation
  • Ambulance Services
  • Mental Health Services

Medicare will also pay for a second opinion on a surgical procedure. Restrictions do apply, so check with your local provider.

Costs

Part B's monthly premiums change annually. For 2020, the monthly premium is $144.60; however, the premium is higher for those individuals who have an IRS-reported income of more than $87,000.

A late enrollment fee is assessed if you did not sign up for Part B when you registered for Part A. The fee is added to your monthly premium as long as you have Part B.

If you're tired of sorting through Medicare information on your own, contact our team. We are readily available to assist over the phone, over video conferencing. Call today!