Understanding Medicare: Part B

Jolie

Member
Helps with doctor visits, hospital and clinic care, lab tests, and some screenings and skilled nursing care.

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You don’t have to sign up for Part B, but most people do.

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What providers can I see?

You can choose any qualified provider who is eligible to participate in Medicare and who is accepting new patients.

Coverage limits.

There are limits on a few services—for example, the amount Part B will pay for occupational therapy and screening are covered only for specific times.

What is covered.


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Examples of the most significant items Part B will help you with. For a comprehensive list, go to www.medicare.gov.

What isn’t covered.

Part B covers eyes, teeth, or hearing only in certain situations. It usually doesn’t cover care outside the United States. It doesn’t offer help with things like eating, bathing, or getting dressed.

Costs.

Premium. This depends on your yearly income—and it can be automatically deducted from your Social Security benefits. For 2010, premiums range from $96.40 to $353.60 a month.

Your share of the costs.

Deductible. Before Part B starts paying a share of your costs, you first have to pay a deductible. In 2010, it’s $155 for the year.

Copay. In 2010, outpatient hospital services copays range from a few dollars up to $1,100.

Coinsurance. After you pay your deductible, Part B generally pays 80%.

Enrolling

When can I join? As soon as you become eligible for Medicare. You can also join later on, but only at certain times of the year.

How do I sign up? If you’re getting Social Security benefits when you become eligible, you’ll be automatically enrolled. Otherwise, you can sign up at your Social Security office.

Can they refuse to cover me or delay coverage? Not if you’re eligible for Medicare.
You can’t be refused Part B because of your medical history or a pre-existing illness.


 
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