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Why Do I Pay Medicare Part B

Why Do I Pay Medicare Part B?

When a person becomes eligible for Medicare Part B, that event depends generally on 1 of 4 items occurred.

  1. You became disabled and were granted Social Security Disability Benefits 2 years prior
  2. You have or became diagnosed with ESRD (End Stage Renal Disease)
  3. You have just turned 65.
  4. You already are 65 or older and you had previous coverage through an employer and are losing that coverage

You will pay to Medicare a premium of $121.80 per month, but some Medicare beneficiaries my pay more because of the income you make.

What does Medicare Part B cover?

Every person that has worked at least 40 quarters receives Medicare Part A. Then if any of the above 4 items occurred you can get Medicare Part B.  Part B covers medical services, IE, doctors, testing, durable medical goods etc.  Medicare Pays 80% and you are now responsible for the balance of 20%.  There are 3 ways to cover that 20%.

  1. You Pay it
  2. You purchase a Medicare Supplement
  3. You enroll in a Medicare Advantage Plan.

What are Medicare Supplements?

Medicare Supplements are underwritten by private insurance companies and must follow all rules that Medicare require. Medicare Supplements are named A-N. Each plan has different benefits that will cover the 20% that you will be required to pay. You are eligible for these plans under open enrollment without qualifying medically. After your Open Enrollment period; 3 months before, the month of, and 3 months after your birthday month, you will go through a health underwriting. Medicare Supplements do not cover prescriptions.

What are Medicare Advantage Plans?

Medicare Advantage Plans are produced by private insurance companies and approved by Medicare. Medicare pays the plan a portion of your Medicare Part A and Medicare Part B benefits.  Then the insurance company pays your Medicare claims.  In most cases, you will pay Co-pays for all services up to a MOOP (Maximum out of Pocket), after that the insurance company pays 100% of your medical claims.  Most Medicare Advantage plans include a Medicare Part D plan that covers your prescription drugs with limitations.

At DAVIS INSURANCE, we can navigate all the questions and answers that you may have about your Medicare benefits.

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