Medicare Part B is one brick of Original Medicare, commonly known as medical insurance. Medicare Part B covers the following outpatient services: doctor`s office visits, physical therapy, preventive services, outpatient mental health care, durable medical equipment, chemotherapy, flu shots, diabetes screenings, and alcoholism counseling.
This blog will answer all questions regarding Medicare Part B in New Jersey.
What is the difference between Part A and Part B of Medicare?
Medicare Part A is hospital insurance, and it covers services provided to you while staying in the hospital. Medicare Part B is medical insurance that covers medical services provided to you as an outpatient. Part A and Part B are not in competition, they are complementary and together they make Original Medicare. The general recommendation is to have both Part A and Part B.
Can a person have Medicare Part B only?
It is always wise to have both Medicare Part A and Part B, but you have the option of disenrolling from Medicare Part A. You can buy only the Medicare Part B policy if you want, as long as you meet the standard eligibility requirements for Medicare. The most common reason for this is that people do not qualify for premium-free Part A, and then choose not to enroll in it at all, leaving with Part B only.
What are the medical benefits of having Medicare Part B?
Medicare Part B gives coverage for medically necessary services, including doctor`s office visits, diagnostic tests, outpatient services, home health services, durable medical equipment, and preventive care services.
What does Medicare Part B not cover?
Part B does not offer coverage for services that are not considered medically necessary. These services are usually cosmetic surgeries and procedures, acupuncture, homeopathy, long-term care, dental services, hearing services, and vision services.
Does Medicare Part B cover 100%?
If you are paying regularly your Part B premium, together with coinsurances, copayments, and the deductible, your Medicare Part B will pay 100% of costs related to your health services provided under Part B coverage.
Does everyone pay the same for Medicare Part B in New Jersey?
As for copayments, coinsurances, and deductibles, everyone pays the same amount. As for the premium for Medicare Part B, in New Jersey, each beneficiary will pay a premium based on their income. In general, individuals with high incomes will have higher Medicare premiums.
Is Medicare Part B free if you are over 65?
No, it is not. With Medicare Part B you are required to pay a monthly premium (which is $164.90 in 2023) together with coinsurance, copayments, and deductibles. However, Medicare Part A is premium-free for most beneficiaries.
Does Medicare Part B pay for prescription drug coverage?
Generally, Part B does not cover prescription drugs. For prescription drug coverage, you need to enroll in Medicare Part D or in some Medicare Advantage plan that includes the extra benefit of Part D in their coverage. However, Medicare Part B covers a limited number of prescription drugs if deemed medically necessary under certain conditions.
Is Medicare Part A and Part B free in New Jersey?
Medicare is regulated by the federal government, and its rules apply to every state, New Jersey included. Medicare Part A is free for most beneficiaries who have been paying their Medicare taxes while working for at least 40 quarters. On the other hand, Medicare Part B is not free, beneficiaries are required to pay a monthly premium, coinsurance, copayment, and annual deductible.
Do I have to pay for Medicare Part B?
Yes, you are required to pay for a monthly premium, coinsurances, copayments, and annual deductible. The standard monthly premium for Part B is $164.90 in 2023. Coinsurance is a cost-sharing benefit where Medicare pays for 80% of the costs and you are responsible for 20%. Copayment is a fixed out-of-pocket expense that you pay for every medical service provided. Medicare Part B deductible is $226 in 2023.
For more out-of-pocket charges regarding Medicare Part B, read our blog about Medicare Part B excess charges.
Is Medicare Part B premium automatically deducted from the Social Security account?
If you are getting benefits from Social Security then your monthly premium for Part B will be automatically deducted from your Social Security account. If you do not receive Social Security benefits then you will get a premium bill from Medicare that you are required to pay on your own.
Can I drop Medicare Part B anytime?
You can opt-out of Medicare Part B at any time. But have in mind that you cannot do it online, because you will be required to do a personal interview with Social Security to review your risk of dropping coverage and to assist you with everything related to your request, mostly documentation.
What is Medicare Part B premium in 2023?
The standard monthly premium for Medicare Part B in 2023 will be $164.90. However, individuals with higher incomes will have higher premiums.
How much does Medicare Part B take out of your Social Security account?
If you are receiving Social Security benefits and you are enrolled in Part B, then the Medicare Part B monthly premium will be automatically deducted from it. In 2023, the standard Part B premium is $164.90.
What is considered high income for Medicare Part B?
The income range for calculating Medicare Part B premiums is sorted through six income levels:
- Individuals with income up to $91,000 and couples with income up to $182,000 will have the standard monthly premium ($164.90 in 2023)
- Individuals with income higher than $91,000 and up to $114,000 and couples with income from $182,000 up to $228,000 will have $68 added to the standard monthly premium ($232.90 in 2023)
- Individuals with income higher than $114,000 and up to $142,000 and couples with income from $228,000 up to $284,000 will have $170.10 added to the standard monthly premium ($335 in 2023)
- Individuals with income higher than $142,000 and up to $170,000 and couples with income from $284,000 up to $340,000 will have $272.2 added to the standard monthly premium ($437.10 in 2023)
- Individuals with income higher than $170,000 and up to $500,000 and couples with income from $340,000 up to $750,000 will have $374.20 added to the standard monthly premium ($539.10 in 2023)
- Individuals with income higher than $500,000 and couples with income higher than $750,000 will have $408.20 added to the standard monthly premium ($573,10 in 2023)
Why did Medicare Part B premiums go up so much in 2022?
Because of Aduhelm, a new drug for treating Alzheimer´s disease. There was a projected jump in spending because Aduhelm is a very expensive medication, so Medicare has risen its premiums. However, in 2022 Aduhelm`s producer cut the price of medication and CMS has limited coverage for this drug, so regarding that, the premiums will drop in 2023.
Craig W. Hansen is an insurance professional and co-founder of William & Michael Advisor Group LLC and Jersey Insurance Solutions. Craig has served his clients in many facets of the insurance industry, always with the same goal: excellence in service while building solid, long-term, lasting relationships. With over a decade of experience in the insurance benefits industry, Craig’s clients know they can call on him anytime and receive platinum service with a smile.
