Medicare Part B (medical insurance) is a portion of the Medicare federal health insurance program. Medicare Part B covers medical services and supplies that are necessary for the treatment of a health condition. This could include outpatient care, preventive services, ambulance services, and medical equipment.
Medicare was created for people who are 65 or older, certain young people with disabilities, and people with permanent kidney failure requiring dialysis or a transplant, also known as End-Stage Renal Disease (ESRD).
Medicare Part B
Medicare Part B specifically covers medically necessary services and preventative services.
Medically necessary services are those services or supplies necessary to diagnose or treat a medical condition while meeting acceptable medical practice standards.
Preventive services are health care services that prevent illnesses and help to correct health problems early stages when treatment can be most effective. Medicare Part B works so that most pay nothing for most preventive services when they’re provided by a health care facility accepting Medicare.
Medicare Part B Coverage
Medicare Part B covers things like clinical research, ambulance and emergency transport services, durable medical equipment (DME), mental health support services, inpatient and outpatient services, partial hospitalizations, and limited outpatient prescription drugs.
Medicare Part B doesn’t cover eye exams, eyeglasses, contact lenses, acupunctural therapy,
most prescription drugs, in-home health care services, hearing tests or hearing aids, dental examinations, teeth cleanings, x-rays, and other routine dental care.
Your Medicare coverage will be based on 3 important factors. Federal and state laws,
national coverage decisions made by the government about whether Medicare Part B will cover your situation, as well as local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in your area.
The following questions can help you get a better understanding of how to apply or terminate your Medicare Part B, and other information about Medicare health insurance.
FAQ About Medicare Part B Medical Insurance
Below are some of the most frequently asked questions about Medical Part B coverage and medical insurance. If you still have questions after reading this, then don’t hesitate to contact Insurance Professionals of Arizona for answers and support.
How do I apply for Medicare Part B coverage?
Some people automatically receive Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage while others have to sign up. Your situation will more than likely depend on whether you’re getting Social Security benefits.
Medicare is managed by the Centers for Medicare & Medicaid Services (CMS). Social Security collaborates with CMS to enroll people in Medicare. Each year you’re eligible to review your services and plans but you don’t have to renew your subscription to Medicare services. If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty.
Where is the application for enrollment in Medicare Part B (medical insurance)?
You’ll only be eligible to sign up for Part B if you already have Medicare Part A (Hospital
Insurance). If you don’t have Part A and want to sign up, please contact Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
You can sign up for Part B during your Initial Enrollment Period (IEP) when you become
eligible for Medicare, during the General Enrollment Period (GEP) from January 1 through March 31 each year, and If you’re eligible for a Special Enrollment Period (SEP).
How do I terminate my Medicare Part B (medical insurance)?
You can voluntarily stop your Medicare Part B (medical insurance) anytime however, you may have to have a personal interview. A Social Security representative or Arizona Insurance Professional can help you complete form CMS 1763 and terminate your services.
To find out more about how to terminate Medicare Part B or to schedule a personal interview, contact the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778) between Monday through Friday from 8:00 am – 7:00 pm or contact your nearest Social Security office. Insurance Professionals of AZ can also provide aid for your Medicare Part B inquiries.
Who pays for Medicare Part B premiums?
Each month you’ll pay a premium that will be automatically deducted from your Social Security, Railroad Retirement Board, or Office of Personnel Management benefits package. If you aren’t eligible for these benefits, then you’ll receive a bill.
Most people pay the standard premium amount. When your modified adjusted gross income is above a certain amount, you’ll pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare applies the modified adjusted gross income reported on your IRS tax return from 2 years ago because it is the most recent tax return information provided to Social Security by the IRS.
If you have medical insurance do you need Medicare Part B?
If your other medical insurance is a COBRA policy, individual policy, or retiree coverage provided by a union or employer, then your enrollment in both Part A, hospital insurance, and Part B, medical insurance, is necessary. These types of coverages are billed secondarily to Medicare, and they’ll pay for any care that Medicare doesn’t cover.
How do I read the Medicare Summary Notice for Part B?
People with Original Medicare get a Medical Summary Notice (MSN) in the mail every 3 months for their Medicare Part A and Part B-covered services. The MSN shows all the services or supplies that providers and suppliers billed on your behalf to Medicare during the 3-month period, what Medicare paid, and the maximum amount you may owe the provider.
Insurance Professional Support
Insurance Professionals of Arizona have been in the business of supporting individuals with Medicare Insurance since 2008. We use our 47 years of combined industry experience to provide superior customer service and education. We look forward to helping you succeed with your health care choices.