The Basics of Medicare Part B
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Many people in Medicare never need to go into the hospital, but almost everybody sees a doctor or needs diagnostic screenings and lab tests sooner or later. That’s where Part B — known as medical insurance — comes in. The wide range of services it covers includes
- Approved medical and surgical services from any doctor who accepts Medicare patients, whether those services are provided in a doctor’s office, in a hospital, in a long-term-care facility, or at home
- Diagnostic and lab tests done outside hospitals and nursing facilities
- Preventive services such as flu shots, mammograms, screenings for depression and diabetes, and so on, many of which are free
- Some medical equipment and supplies (for example, wheelchairs, walkers, oxygen, diabetic supplies, and units of blood)
- Some outpatient hospital treatment received in an emergency room, clinic, or ambulatory surgical unit
- Some inpatient care in cases where patients are placed under observation in the hospital instead of being formally admitted
- Inpatient prescription drugs given in a hospital or doctor’s office, usually by injection (such as chemotherapy drugs for cancer)
- Some coverage for physical, occupational, and speech therapies
- Outpatient mental health care
- Second opinions for non-emergency surgery in some circumstances
- Approved home health services not covered by Part A
- Ambulance or air rescue service in circumstances where any other kind of transportation would endanger the patient’s health
- Free counseling to help curb obesity, smoking, or alcohol abuse
You must pay a monthly premium to receive Part B services unless your income is low enough to qualify you for assistance from your state. Most people pay the standard Part B premium, which is determined each year by a formula set by law ($134 per month in 2017). If your income is over a certain level, however, you’re required to pay more.
You also pay a share of the cost of most Part B services. In traditional Medicare, this amount is almost always 20 percent of the Medicare-approved cost. Medicare Advantage health plans charge different amounts — usually flat dollar co-pays for each service.