Medicare Part B Benefits

Medicare Part B helps pay for:

  • Physician services (inpatient and outpatient)
  • Durable medical equipment and supplies
  • Home health care
  • Diagnostic and lab tests
  • “Welcome to Medicare” physical exam
  • Diabetic screening, services and testing supplies
  • Glaucoma testing
  • Screening mammograms/Pap Tests
  • Vaccinations (flu, pneumonia, hepatitis)

This is an incomplete list. To learn the details about Medicare Part B benefits, visit Understanding Medicare 2016 or What Part B Covers

Medicare Part B Costs

It is important that you sign up for Medicare Part B when you are first eligible. Not enrolling in Medicare when you are eligible may result in financial penalties and time delay for enrollment.

The standard Part B premium is $121.80 per month in 2016 if your countable income is equal to or below $85,000 for an individual or $170,000 for a couple. Higher premiums are charged for incomes above these levels. The amount is determined by Social Security.

If your Yearly Income on your Tax Return is:

Your Part B Premium is:

Individual Tax Joint Tax  
$85,000 or less $170,000 or less $134.00
$85,0001 – $107,000 $170,001 – $214,000 $187.50
$107,001-$160,000 $214,001-$320,000 $267.90
$160,001-$214,000 $320,001-$428,000 $348.30
Above $214,001 Above $428,001 $428.60

However, many people will continue to pay a Medicare Part B premium of $104.90 in 2016.  This includes those people already on Medicare who receive Social security benefits and had a 2014 income of $85,000 or less (single) or $170,000 (couple). 

The Part B annual deductible for 2015 is $183.00 and there is a 20% copayment for Medicare approved charges and services. Medicare pays 80% of the Medicare-approved amount. If a provider accepts assignment he/she agrees to accept the Medicare approved amount for services provided. Providers who do not accept assignment may charge 15% above the Medicare approved amount. This is called the “Limiting Charge”.

Some Common Services Not Covered By Medicare

  • Long term custodial care (nursing home)
  • Private hospital room (medically necessary); Private duty nursing
  • Ambulance Services (unless medically necessary)
  • Routine physical care, other than the “Welcome to Medicare” exam
  • Routine dental care and dentures; hearing exams and hearing aids
  • Routine eye exams and eyeglasses (except cataract lenses)
  • Routine podiatry care; Acupuncture, most Chiropractic Services
  • Christian Science practitioners and Naturopath’s services
  • Orthopedic shoes, unless part of a leg brace or nerve defects due to diabetes; Cosmetic Surgery
  • Services provided outside the United States (with some exceptions)

Part B Resources