Medicare Part B Coverage
Medicare Part B covers essential medical services such as doctor's services, blood, and outpatient treatment among others. This plan also includes a one-time physical exam during the first twelve months of your coverage.
If you were enrolled in Plan B in 2008, you are required to pay only 20% of the approved amount by Medicare and without deductibles.
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Based on Medicare information, you are automatically signed up for Plans A and B if you are already eligible to receive your retirement benefits from Social Security. While getting rid of your Plan B coverage can be fairly easy, you might want to reconsider what you will lose if you do not wish to forego this coverage.
Medicare Part B Coverage
Medicare Part B automatically becomes one of your health care coverage once you enroll in Medicare. Under this plan, you are covered by medical insurance as well as certain preventive services. Part B is run by the federal government although you are subjected to pay a certain amount as monthly premium. Plan B covers essential medical services such as doctor's services, blood, and outpatient treatment among others. This plan also includes a one-time physical exam during the first twelve months of your coverage. But if you were enrolled in the plan in 2008, the service now requires a minimum fee: 20% of the amount approved by Medicare less deductibles.
Based on the publication issued by Medicare, Medicare Part B has some of the following covered services:
- Services provided by doctors which do not include routine physical exams
- Medical and surgical services as well as supplies for outpatient care
- Fees for ambulatory surgery center for procedures approved
- Durable medical equipment
- Laboratory tests
- Health care service at home which is limited to those necessary medical treatment on a part time or irregular schedule
- Hospital services for outpatients forming part of those provided by doctors
Preventive Services
Another important service under Part B is preventive services. This kind of service is offered as a way to diagnose health problems earlier--at a time when treatments are more effective. For this kind of service, card holders may be required to pay additional for co-insurance or a deductible will be required or a combination of both. Aside from the one-time physical check up, here are some of the services under this coverage, the duration of which lasts for a minimum of 12 months.
Screening for abdominal aortic aneurysm - Measurements for bone mass
- Screening for cardiovascular
- Screening for Colorectal Cancer
- Screening for Diabetes
- Shots for Flu
- Tests for Glaucoma
- Shots for Hepatitis B
- Examination Pelvic and Test for Pap
- Shots for Pneumococcal
- Screenings for Prostate Cancer
- Mammogram Screenings
- Smoking Cessations Sessions
Eligibility
Eligibility for Plan B is the same with Plan A with the added requirement that you pay a premium of $96.40 per month. The amount may increase depending on your income. The requirements are indicated below.
For Ages 65 and above
- You or your spouse has been employed for a minimum of ten years in an employment covered by Medicare.
- A bona fide citizen of the United States
- You have begun to receive your retirement benefits from Social Security or the Railroad Retirement Board
* However, if you do not receive retirement benefits from Social Security, you will be eligible for Medicare upon reaching 65 years old.
For Below 65
- You have been receiving your retirement benefits from Social Security or Railroad Retirement Board for at least two years
- You either have a disability or are suffering from End-Stage Renal disease subject to additional requirements by Medicare
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Premium
However, unlike Plan A, Plan B has premium costs for medical insurance coverage. It is your choice as a plan holder if you want to retain your Plan B coverage. The date the enrollment becomes effective under this plan can be seen on the front of your Medicare card. A plan holder who opts to forego this plan must inform Medicare before the effectivity date. For the year 2009, a monthly premium cost for Part B is $96.40. But your monthly income may command for higher premium payments, such as if you are single, your yearly income is above $85,000, or your combined annual income with your spouse is above $170,000. These premiums can change every year.
Exclusions
Medicare Part B, however, does not cover all medical services. You will notice that the list of services provided above is exclusive. Routine physical exams are not included in the coverage, neither is medical and surgical services for inpatient care. While home health care service is provided, it does not cover regular service, only intermittent ones. So before you decide whether you will keep your Medicare Part B, better check first if the service you need falls under the listed categories.