A basic understanding of Medicare helps you get the most out of your health care coverage. The first thing you need to understand is that there are two different parts to Original Medicare: Part A and Part B.
Medicare Part B covers medical services and supplies considered medically necessary to treat your health condition. This includes outpatient services, preventive care, ambulance services, and durable medical equipment.
Some preventive services are also included within Medicare Part B, including a one-time preventive visit, flu, and cardiovascular screenings, hepatitis B shots, cancer and diabetes screenings, and other services.
Medicare Part B is an automatic enrollment for some, and others will need to sign up.
Medicare Part B premiums change from one year to the next, and the monthly premium varies based on your income and personal circumstances.
Your Part B premium will be deducted automatically from your benefit payment if you receive benefits from Social Security, Railroad Retirement Board, or Office of Personnel Management. If you don’t receive benefit payments, you’ll receive the bill.
Medicare Part B uses your tax return from two years earlier to determine the monthly premium you will pay. For 2022, your 2021 return will be used.
The standard Part B premium amount in 2021 is $148.50. Unless your individual income exceeded $87,000 or your joint income was more than $174,000, you will pay this monthly premium.
Additionally, Medicare Part B beneficiaries need to pay the annual deductible fee of $203 in 2021. The increase from 2019 is primarily due to rising spending on physician-administered drugs.
The deductible is the amount of money you will need to pay in out-of-pocket costs before the plan starts coverage. For example, in 2021, the yearly deductible for Medicare Part B is $203, and coinsurance of 20% for several covered services.
How much you will pay for Part B-covered services depends if you visit a participating or non-participating provider.
Participating providers (physicians or healthcare professionals) accept Medicare’s approved amount for a service, and you will be responsible for the Part B deductible along with 20% of the approved amount.
Some providers, however, do not accept Medicare’s approved amount. These non-participating providers did not sign an agreement with Medicare and can charge up to 15% more than Medicare’s approved amount, meaning you’d be responsible for the 20% coinsurance plus 15%.
Fill in the Medicare payment coupon and post to:
Medicare Premium Collection Center
PO Box 790355
St. Louis, MO 63179-0355
If you have limited income and assets, you may qualify for financial assistance to help pay Medicare Part B premiums. The Medicare Savings Program provides three different programs that can help you cover your Medicare Part B costs.
To qualify, the requirements for the three programs are as follows:
Qualified Medicare Beneficiary (QMB). Monthly income must be less than $1,083 for individuals and $1,457 for couples, and resources cannot exceed $7,860 for individuals and $11,800 for couples.
Specified Low-Income Medicare Beneficiary (SLMB). Monthly income must be less than
$1,296 for individuals and $1,744 for couples and resources cannot exceed $7,860 for individuals and $11,800 for couples.
Qualified Individual (QL). Monthly income must be less than $1,456 for individuals and
$1,960 for couples and resources cannot exceed $7,860 for individuals and $11,800 for couples.
‘Resources’ includes any money in a checking or savings account, stocks, and bonds.
Many types of medical expenses are tax-deductible. For example, under the U.S. tax code, you can deduct Medicare expenses (including premiums) that exceed a certain percentage of your income.
If you have any questions about the Medicare Part B premiums you can expect to pay and your eligibility for financial assistance, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.