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Medicare Part B

Medicare Part B was created to help cover additional medical-related expenses that are not covered under Medicare Part A (the hospital benefit). After a deductible is met, Medicare Part B pays 80% of what the government considers to be the “reasonable charge” for covered services. The covered individual must then pay the remaining 20% of the charges. The “reasonable charge” will usually be less than the actual amount charged. Some providers will accept Medicare’s “reasonable charge” and not charge the patient the additional 20% for some services. If not, the patient is responsible for this amount.

Currently, individuals who received Social Security retirement benefits or who received Social Security disability benefits for 24 months, or those entitled to Medicare Part A, are automatically enrolled in Part B. They do have the option to decline coverage. Others can enroll in Part B by completing a request form at the Social Security office during certain enrollment periods.

Medicare Part B is the benefit that pays for physicians’ services. It also covers clinical research, ambulance services, home health care, durable medical equipment (DME), outpatient physical therapy, x-rays, diagnostic tests, some drugs and supplies. This benefit is generally for services and medical assistance devices utilized on an outpatient basis.