Medicare Part B is Medical Insurance that pays for Medicare covered Out-Patient services, sometimes called “The Doctor’s Part”.
Medicare covered services are those that Medicare deems Medically Necessary: Services or supplies that are needed to diagnose or treat a medical condition and that meet accepted standards of medical practice.
Medicare Part B Premium
For most people (2021):
More About Medicare Part B Premium
Anyone who is eligible for Medicare Part A at no cost can enroll in Medicare Part B by paying a monthly premium. For most people receiving Social Security benefits, they will automatically deduct $148.50 (2021) from your benefit payment.
If you do not receive Social Security benefits, you will get billed quarterly for your Part B premium, or $445.50 (2021).
If you are not eligible for Part A at no cost, you can buy Part B, without having to buy Part A, if you are age 65 or older and meet certain criteria.
Some people with higher incomes will pay higher monthly Part B and Part D premium, called Income-Related Monthly Adjustment Amount (IRMAA). More about the rules for higher-income beneficiaries can be found here
$203 Yearly Deductible (2021)
A small yearly deductible for out-patient Medicare covered services. After you meet the deductible for the year, you typically pay 20% of the Medicare-approved amount.
Medicare Approved Charges
After you’ve met the deductible, then Medicare pays 80%, you pay 20% and any excess charges.
More about Medicare-Approved Charges
Medicare has a fee schedule for each service or procedure. If a provider accepts Medicare assignment, it means they accept the Medicare approved amount as payment in full for covered services.
Although rare, in most states a provider can charge up to 15% more than what Medicare says is ok. Medicare will only pay 80% of the approved charge, so the up to 15% Medicare Part B Excess charge can be passed on to the patient and billed to you.
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