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Medicare Part B

Medicare Part B is medical insurance.

Covered:

  • Doctor Visits
  • Outpatient Care
  • In-Home Healthcare
  • Durable Medical Equipment
  • Preventative Care

Not Covered:

  • Hearing
  • Dental
  • Vision
  • Alternative services

Part B is optional, and there is a monthly premium for Part B benefits. In 2022, the monthly premium for Part B is $170.10. It can be more if your income is above a certain level. But for most people they will pay $170.10 per month to have Part B of Medicare.

That might sound like a lot, but if you didn’t have health insurance coverage through work, you most likely would be hit with a monthly premium double or even triple that to have health insurance. If you qualify as low income, there are options that I’ll address further down to pay the premium.

In addition, Part B also has a deductible just like Medicare Part A. The annual deductible for 2022 is $233. So that means that you have to pay $233 first, then Uncle Sam will start chipping in his share. Once Uncle Sam is paying his part he is covering 80%,  and you have to pay 20% of the remaining costs. You may also have to pay any excess charges that a provider may charge beyond what Medicare will reimburse. 

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Example

Imagine a service like a surgery or chemotherapy. Let’s say the cost for treatment is $100,000, which could actually be on the low end of treatment costs. In any case, with Original Medicare Part A and B only, (AKA- Uncle Sam’s plan), your 20% of cost sharing is $20,000! For most people I meet with, not only do they not have an extra $20,000, but even if they did, $20,000 is coming from their retirement savings and that puts a dent in it for sure. There is however a solution, and that is Part C.

Enrollment

Enrolling in Medicare Part B is the same as enrolling in Medicare Part A. If you already have Social Security then auto enroll happens, and Uncle Sam will automatically deduct his cut for Part B premiums from your Social Security check. Uncle Sam gets his, then you get yours. However, if you are not enrolled in Social Security then you actively have to enroll in Medicare Part B by phone, in person, or online at ssa.gov.

There’s a credit card option at the bottom of the quarterly invoice, if that’s what you elect to do. To pay by credit card is as easy as completing the payment coupon and mailing it into the Medicare Premium Collection Center.

You also have the option to use Medicare easy pay, which is a FREE auto draft service that works like any other auto draft. Once set up it links to your preferred checking or savings account, and automatically deducts payments on a monthly basis.

Late Penalty

Another wild card that Uncle Sam threw into Medicare part B is a late enrollment penalty.

What that means is that if you did not sign up for Medicare Part B when you were first eligible, and you didn’t have any credible coverage from let’s say an employer, then you will be subject to a Medicare part B late enrollment penalty.

Uncle Sam doesn’t like it when his nieces and nephews do not play by his rules, so it’s in your best interest to follow them. This penalty is equal to 10% per year for every year that you waited to enroll and it applies for life

Now, if you have creditable coverage from an employer for Part B then you can delay enrolling in Part B. But once you retire or lose that creditable coverage your clock starts. Uncle Sam gives you 8 months after leaving that coverage to sign up before the late penalty is assessed.

In general, it is a good idea to just enroll in Part B during your initial enrollment. Period

Help With Paying Part B Monthly Premium

Now most of the people I meet with are on fixed incomes. And paying $170.10 per month is a lot of money.

Solution:

  • Get a Medicare Part C plan. This is also known as a Medicare Advantage plan, and it will help with medical costs.
  • See if you qualify for Medicaid, (In California it’s called Medi-Cal).

This essentially is state aid that will help with the costs. It’s based on income, but it doesn’t hurt to see if you qualify. 

Many of the members I meet with in LA County have some level of financial assistance and most have their Part B premiums paid for. 

The ones that do not qualify because according to Uncle Sam they make too much money, (LOL) usually opt-in to a MAPD where they receive money directly deposited onto their Social Security paycheck, to ofset the cost of Medicare Part B premiums.

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