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Medicare Part B Benefits

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Part B Medicare Benefits cover a variety of procedures that are not covered under Part A Benefits. Like other Medicare Benefits, those who are working are able to put off enrolling for Part B Benefits, which are optional, however those who are not working and do not enroll will face a 10% increase in premiums each year.

To Enroll in Medicare, including Part B Benefits, you can visit their site here.

While Part C is used to cover prescription medicine, Part B will cover medication that is given by a doctor. It also covers some doctors visits, x-rays, blood tests, chemotherapy, ambulance transportation, and a number of other outpatient treatments, such as vaccination for the flu.


Durable Medical Equipment

One of the most important parts of Part B Benefits, however, is the coverage of Durable Medical Equipment. Durable Medical Equipment refers to a number of different types of home medical equipment, such as hospital beds and wheelchairs, as well as things like eye glasses, oxygen equipment, and prosthetics.

In most cases, Medicare will cover 80% of the cost of the equipment, with the insured being responsible for the remaining 20%. It is almost always necessary to have a doctors prescription and certain types of equipment will also require a Certificate of Medical Necessity, which is simply a much more detailed prescription that outlines the specific conditions the patient has. Certain equipment will have some extra requirements that the patient must meet, such as someone who wants to have their mobility scooter covered would need to use it all of the time, both at home and away, and not merely when away from home.

While the majority of medical equipment covered under Part B Benefits is covered up to 80%, this is not the case with all types. Lift Chairs, which are basically recliners that act as a standing aid, are one example, as they are only partially covered. They also require a Certificate of Medical Necessity, which among other things, requires that the patient can not stand from any chair in their home. Usually Medicare will be reimbursed for about $300, which covers the cost of the lifting mechanism, but the entire chair is not covered. Getting reimbursement is not always easy either.

Other items, specifically those that involve home modification are not usually covered under Medicare Part B. For example, widening the doorways for a wheelchair user or installing an elevator would not be covered.

Cost of Part B Benefits

A monthly premium is required for those wishing to use Part B Benefits, which is usually around $100. However, since 2007, the premium is also based off of income and whether the insured is married, with a higher income meaning a higher premium and can be as high as $300.

In addition to a monthly premium, the patient must also pay a yearly deductible if they use these benefits, which was around $130 in 2009. There is also a copay required for most items, which is usually 20% of the cost of the item, with Medicare paying the other 80%. However, as stated above, some items, like lift chairs Medicare, are only partially covered under Medicare. However, blood work and other laboratory services are often covered completely. A 15% surcharge is added if the physician is not certified by Medicare.

What is Medicare?

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Medicare is a health insurance program that was established by the federal government in 1965. It was part of the Social Security Act of 1965, which was signed by President Lyndon Johnson on 30 July, 1965. Arguably, Medicare is a type of socialized medicine, which is administered by the Government, but since the actual medicine and treatment is preformed by private doctors and the governments role is more of as a supervisor, Medicare would technically be a Social Insurance Program.

Those that qualify for Medicare are able to receive reimbursement for their medical costs, including doctors visits and medical equipment, but as of recently, also prescription medication.

How is Medicare Funded

Medicare is paid for by taxes, which are taken out of workers paychecks. Currently, 2.9 percent of a persons income is taken for Social Security taxes, with the employee paying half of this and the employer paying the other half.

Part of the requirements for participating in Medicare, or at least participating without paying extra fees, is that the person has paid enough money into Medicare throughout their life.

Requirements for Medicare Coverage

Medicare is designed primarily to help cover the medical costs of those who are over 65, legal residents of the United States, and have been paying taxes for at least 10 years. However, in certain cases, usually due to disability, Lou Gehrig’s Disease, or renal failure, it may be possible to receive Medicare Benefits before the age of 65.

Currently, congress is discussing allowing those who are over 55 to buy into Medicare Early, as part of the current health care reform that is taking place in Congress. This is, however, still under wraps, so it remains to be seen if this will make it into the final bill and what the buy in cost will actually be.

What is Covered By Medicare?

This is something that I will go into further in my later posts and will update this one as well, but Medicare covers doctors visits, certain hospital stays, many types of home medical equipment, as well as prescription medicine.

However, when you sign up for Medicare, you are given the opportunity to decide what type of coverage you would like to receive. The different types are decided into Parts, such as Part A Medicare and Part B Medicare, and you will usually be given the opportunity to enroll in whichever parts you qualify for.

Those who have insurance through an employer can usually wait on deciding without penalty, but otherwise, adding on coverage later, especially prescription medicine coverage, will have a few hurdles.

In addition to Government Run Plans, it is also possible to sign up for a Medicare Advantage Plan, which is actually run by a private insurance company, but because these are allowed to be slightly different from traditional Medicare, it is imperative to carefully read the plan and compare it to regular Medicare.

How can I Find Out More Information About Medicare?

I would encourage you to check back at this blog regularly, as we will be updating it with more information about how Medicare Works, what Medicare Covers, and current news events.

With that said, one of the best places to find out about Medicare is to visit the official Medicare site. They have a tremendous amount of information for those on Medicare or curious about how it works, including sections to find out Your Medicare Coverage.