Also known as “Medical Insurance,” Medicare Part B is one of the two main parts of Medicare, along with Part A. It covers medically necessary services and supplies needed to treat or diagnose a medical condition, including doctor’s services, outpatient care, preventive services, and durable medical equipment.
The amount you pay monthly to have Medicare Part B coverage. Premiums can vary based on income and are typically deducted from your Social Security, Railroad Retirement, or Civil Service Retirement payment.
The annual amount you must pay out-of-pocket before Medicare Part B begins to pay for covered services. Once you meet your deductible, Medicare typically covers 80% of the Medicare-approved amount for covered services.
The percentage of the Medicare-approved amount for covered services that you’re responsible for paying after meeting your deductible. For Medicare Part B, the coinsurance is typically 20%.
Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.
Healthcare services intended to prevent illness or detect it at an early stage when treatment is likely to be most effective. Examples include screenings, vaccinations, and counseling.
Medical services or procedures that do not require an overnight hospital stay. This can include visits to a doctor’s office, outpatient surgery, diagnostic tests, and therapy services.
Equipment that is durable (can withstand repeated use), used for a medical purpose, and appropriate for use in the home. Examples include wheelchairs, oxygen equipment, and walkers.
The amount that Medicare determines to be reasonable for a covered service or item. Medicare typically pays this amount directly to healthcare providers, and it may be less than the actual amount charged by the provider.
The additional amount that a healthcare provider is legally allowed to charge for a covered service or item if they don’t accept assignment (the Medicare-approved amount). These charges are limited to 15% above the Medicare-approved amount and are the responsibility of the beneficiary.