Medicare Part B is the “outpatient” portion of the original Medicare program.  You’ll be charged a premium for Part B, starting at $135.50 per month and increasing if your “Modified Adjusted Gross Income” exceeds $85,000 for single filers, $170,000 for joint filers.  The government will look at your tax return for 2017 for enrollments in 2019.  If you earned more than this, you’ll want to review the information in the Premiums for higher income beneficiaries 2019.

 

If you are subject to the higher premium, but you’ve had an income reduction since the tax year used to determine your premium  (perhaps you are retiring or cutting your hours back at work), the government will consider your specific situation and may remove this higher premium.  This is the form you can use to get that process started:  ssa-44 for 2019

Part B has a $185 calendar year deductible in 2019.  Doctor visits and most outpatient services are covered at 80% by Medicare.  This is 80% of the Medicare Allowed Amount.  You can receive services from any doctor in the U.S.A. who bills Medicare.  Some of these doctors “Accept Assignment” (which means they accept the Medicare Allowed Amount as payment in full).  When you use a doctor who Accepts Assignment, your cost will be the deductible of $185, plus 20% of the allowed amount.  Doctors who will bill Medicare, but do not accept assignment may charge an additional 15%.  You can avoid some or all of this liability by purchasing a Medicare Supplement or Medicare Advantage plan.

If you receive services from a doctor that will not bill Medicare, YOU WILL BE RESPONSIBLE FOR THE ENTIRE COST OF THEIR SERVICES.  Fortunately, most doctors in our area will bill Medicare, but many mental health professionals, alternative medicine specialists, and “boutique” doctors do not.  We recommend you ALWAYS ask before you make an appointment!  Medicare’s website also provides a page where you can research providers.

Part B includes some coverage for Skilled Home Health Care (not custodial care) if your condition meets certain guidelines and you’re considered “Homebound” and your doctor will certify that you are.   See the Medicare and Home Health Care publication for helpful details.  In many cases, your supplement will also pay the balance on these covered services as well.