Medicare Part B and D coverage and cost

Medicare Part B and Part D

As an insurance verify Medicare part B are outpatient services. Someone under Observation, the Emergency room, coming in for an outpatient procedure or diagnostic service would be outpatient.

This also is visits to your doctors or screenings. Preventative services (like a mammogram) that you do at the recommended intervals are usually done at no out of pocket for you.

If you are working and have an employer sponsored plan, most of the time you can hold off starting Medicare Part B. If you opt for this, there is a downside. One is that you get sick quickly and you have a time lag between when you lose your employer sponsored plan and your Medicare part B coverage kicks in.

There are advantages to waiting – but that is a conversation you need to have with a financial adviser for your situation and is way to complex for a blog post.

Part B is not free. You pay a monthly premium for part B and it is based on income.

This information is medicare.gov. if you are reading these 2 years from now, you can go online and find the information that is current on pricing.

You monthly payment will be If your income was (looking at just a few of the entries in the grid for individual.  The entire table can be found on Medicare.gov)

$135 if you made $85k or less as an individual

$189.60 if you made between $85k and $107k

$433.40 if you made between $160k to $500k

You have a copay of $185 per year and you pay 20% coinsurance

My mom had social security through my dad. Her SSI check was $1100 a month. She was over income to qualify for Medicaid, but she still had to pay the $135 dollars out of that SSI check. She had it taken out of her SSI check.

There is a penalty for not enrolling when you are eligible. 

Oh - if you don’t make your payments, you can lose your Medicare coverage.

Part A is Acute services – Hospital

Part B is the Outpatient and Preventative services – screenings, ER DR, labs

What about drugs

That is Part D. You buy that separately.

I went to one of the popular plan groups. I figured the cost of this plan would be average.

Part D monthly premium for a

Specific pharmacy $28 a month

Choice, but don’t take medications is $33.88

Choice and you take medications is $76

These all had copays or formularies, just like we have in our commercial insurance plans.