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What is the cost of Medicare Part B?

 

People generally pay a monthly premium for Medicare Part B. If you can’t afford to pay the Part B premium, there are programs that may help. Usually, the premium is automatically taken out of your monthly Social Security or Railroad Retirement payment. If you are a Federal Government retiree, you may be able to have the premium deducted from your retirement check.
If the cost of the premium cannot be deducted from a federal benefit, Medicare sends you a bill for your Medicare Part B premium every three months. You may pay your bill by credit card, check, or money order. You may also choose to have your Part B premium automatically deducted from your bank account using the Easy Pay option. (You may also use Easy Pay if you pay a premium for Part A.) You can contact 1-800-MEDICARE (1-800-633-4227) and request a Medicare Easy Pay Authorization Form. TTY users should call 1-877-486-2048.
Some people with higher annual incomes pay a higher Part B premium. These amounts can change each year.  
The income ranges for joint returns are double that of individual returns. Social Security uses the income reported two years ago on the income tax return to determine the Part B premium. For example, the income reported on a 2007 tax return is used to determine the monthly Part B premium in 2009. Under certain circumstances people can ask that the income from a more recent tax year be used to determine the premium. For more information about premiums based on income, call Social Security at 1-800-772-1213.

Other costs

You are responsible for paying an annual deductible every year in which you receive care covered by Medicare Part B. Excess and non-covered charges do not apply toward this deductible. Examples of care that would not count toward the deductible include home health services, clinical laboratory services, and some preventive services.
 
For some Part B services, Medicare pays 80% of the approved amount; you are responsible for the remaining 20%. For other Part B services, the amount varies.
 
For physicians who do not accept assignment – Medicare’s approved amount to pay for their services – you can be billed up to 15% more than the approved charge.  In some cases, you can be responsible for the balance due to the physician.
 
The following providers are required to always accept assignment:
 
a.       Hospitals
b.      Skilled Nursing Facilities (SNFs)
c.       Home Health Agencies (HHAs)
d.      Comprehensive Outpatient Rehabilitation Facilities (CORFs)
e.      Ambulatory Surgical Centers (ASCs)
f.        Providers of outpatient physical, occupational or speech therapy services
g.       Clinical laboratories
h.      Ambulances
 
When a provider accepts assignment, they cannot ask for payment in full at the time the service is provided. They may, however, request payment for applicable deductible and coinsurance costs. Provider bills Medicare for services, payment is made to provider.
 
When a provider does not accept assignment, they may charge more than Medicare’s approved amount. Patients are responsible for the excess charges.
 
However, physicians may only charge up to 15% more than Medicare’s approved amount (excess charge). The beneficiary is responsible for the excess charge. Providers who do not accept assignment may choose to do so on a case-by-case basis. When a provider does not accept assignment, they may ask for payment in full at the time the service is provided.
 
For Durable Medical Equipment like wheelchairs and respirators, there is no limit to what may be charged over Medicare’s approved amount. As the beneficiary, you are responsible for this charge.