MEDICARE PART B
• Monthly premiume In 2017, most people pay the Part B premium of $109 each month. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.
The standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits will continue to pay the same Part B premium amount as they paid in 2016. This is because there wasn’t a cost-of-living increase for 2017 Social Security benefits. You’ll pay a different premium amount if:
• You enroll in Part B for the first time in 2017.
• You don’t get Social Security benefits.
• You’re directly billed for your Part B premiums.
• You have Medicare and Medicaid, and Medicaid pays your
• premiums. (Your state will pay the standard premium amount of $134)
• Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount.
If you have low income, you may qualify for extra help that pays for the part b premium. Contact your local Social Security Office to assess your option.
• Late enrollment penalty:
In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B, and coverage will start July 1 of that year.
Part B costs if you have Original Medicare
All Medicare Advantage Plans must cover these services. If you’re in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those in Original Medicare. Review the “Evidence of Coverage” from your plan.
Part B annual deductible:
You pay $183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
Clinical laboratory services:
You pay $0 for Medicare-approved services.
Home health services:
$0 for home health care services.
20% of the Medicare-approved amount for durable medical equipment.
Medical and other services:
You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
In 2016, there may be limits on physical therapy, occupational therapy, and speech language pathology services. If so, there may be exceptions to these limits
Outpatient mental health services
You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.
20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies. If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital. This amount will vary depending on the service provided, but will be between 20-40% of the Medicare-approved amount.
Partial hospitalization mental health services:
You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts assignment. You also pay coinsurance for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, and the Part B deductible applies.
Outpatient hospital services
You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider’s services, and the Part B deductible applies.
For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor’s office.
For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don’t apply (so you pay nothing).