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Exclusive Benefits
  • Coverage
    Medicare Part B is the second part of Original Medicare that covers visits to doctors, durable medical equipment, speech therapy, occupational therapy, physical therapy, and other outpatient services. Additionally, it covers costs involved with clinical research, mental health, ambulance services, durable medical equipment, and some outpatient prescription drugs.
  • Eligibility
    The eligibility criteria for Medicare Part B is same as Part A, which is you have to be either:
    • 65 years of age or older.
    • Terminally ill with certain diseases, such as kidney failure.
    • Younger than 65 years, but have certain disabilities.
  • Limitations
    The only limitation under Medicare Part B is that services for physical therapy, occupational therapy and speech language pathology have annual coverage limits.
  • Considerations
    Here are few factors to consider when looking at Medicare Part B coverage:
    • Part B coverage can be availed anywhere in the US, if you have Original Medicare and the physician accepts Medicare.
    • You can choose any doctor in the US who accepts Medicare patients.
    • Premiums, standard deductibles and cost sharing amounts of Part B generally change annually on January 1st.
Costs Information

Premium

Has a monthly insurance premium that is based on when you enroll, and your annual household income. Usually, this premium is paid through Social Security withholdings and is separate from the health insurance premiums you will pay if you choose Medigap, Medicare Part C or Medicare Part D

Copay

May apply to specific services. For example, services received in an outpatient hospital setting.

Deductibles

You are required to first meet an insurance deductible before you can use Part B to cover your medical expenses

Coinsurance

You pay 20 percent for certain medical services like doctor services, outpatient therapy and durable medical equipment.

Preventive Care

No deductibles, copays or coinsurance are applicable for preventive care services covered by Medicare. These include annual wellness visits and mammograms for women.

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