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What Is Aetna Medicare Part B?

medical insurance + preventative care = Medicare Part B formula illustration

Medicare Part B is half of a national health care program known as “Original Medicare." The other half of Original Medicare is called Medicare Part A. Like Medicare Part A, Medicare Part B is subsidized and managed by the federal government. Most people who are 65 or older are eligible for Medicare Part B.

Learn more about Medicare Part B coverage today.
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What Does Medicare Part B Cover?

Coverage varies depending on your area, but generally Medicare Part B covers two types of services:

Medically necessary services

This includes any outpatient health care service or supply that you may need to treat or diagnose an illness or injury.

Preventative services

This includes any health care service or supply that you may need to help prevent an illness or injury or detect it early on when treatment will be more effective.

Some examples of services or supplies that may be covered by Medicare Part B include:

  • Outpatient doctor’s visits and surgeries
  • Ambulance services
  • Clinical research studies
  • Mental health services
  • Limited outpatient prescription drugs

To find out whether a health care service you need is covered by Medicare Part B, talk to a licensed agent. Your agent can tell you whether the service is covered by Medicare and which health care providers offer it in your area.

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What Is the Medicare Part B Premium?

According to Medicare’s official website, the standard premium amount for Medicare Part B coverage is $144.60 a month. However, depending on your income and whether you’re currently receiving Social Security benefits, your amount may be higher or lower.

Medicare Part B Premiums, 2020
Your Annual IncomeMonthly Amount
If you filed an individual tax returnIf you filed a joint tax return
$87,000 or less$174,000 or less$144.60
$87,000–$109,000$174,000–$218,000$202.40
$109,000–$136,000$218,000–$272,000$289.20
$136,000–$163,000$272,000–$326,000$376.20
$163,000–$500,000$326,000–$750,000$462.70
$500,000 or greater$750,000 or greater$491.60

Note: If you are married but file a separate tax return, you pay $144.60 a month if your yearly income is $87,000 or less. You pay $462.70 a month if you earn between $87,000 and $413,000 a year and $491.60 a month if you earn $413,000 or more a year.

Typically, your Medicare Part B premiums are automatically deducted from your Social Security benefits if you receive them. Just keep in mind that your premium amount may change from year to year.

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Is There a Medicare Part B Deductible?

In 2020, the annual deductible for Medicare Part B medical insurance is $198. You may also have to pay a 20 percent coinsurance for doctor’s visits and other health care services after you meet your deductible.

Here are some examples of what you might expect to pay for certain medical services:
ServiceYou pay …
Medical
  • 20% of the Medicare-approved amount for most doctor's services—including while you're staying at a hospital—as well as outpatient therapy and durable medical equipment (DME)
Clinical laboratory
  • $0 for Medicare-approved services
Home health care
  • $0 for Medicare-approved services
  • 20% coinsurance of the Medicare-approved amount for durable medical equipment
Outpatient mental health
  • $0 for your annual depression screening (if your doctor accepts Medicare)
  • 20% coinsurance of the Medicare-approved amount to diagnose or treat your condition
Outpatient hospital services
  • 20% of the Medicare-approved amount for your doctor's or other health care provider's services
  • A copayment for all other services
Preventative care and health screenings
  • $0 for all Medicare-covered services

Note: If you are married but file a separate tax return, you pay $144.60 a month if your yearly income is $87,000 or less. You pay $462.70 a month if you earn between $87,000 and $413,000 a year and $491.60 a month if you earn $413,000 or more a year.

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Am I Eligible for Medicare Part B?

If you’re eligible for “premium-free” Medicare Part A, chances are you already qualify to receive Medicare Part B benefits. All you have to do is enroll in Part B and start paying the monthly premium.

If you’re not eligible for premium-free Medicare Part A, however, you may be eligible for Medicare Part B coverage if the following applies to you:

  • You are 65 years old or older
  • You are a US citizen or legal permanent resident who has been living in the US for at least five years in a row

If you are disabled, you may also qualify for enrollment in Medicare Part B benefits. If you are under 65 years old, you may qualify for enrollment if one of the following situations describes you:

  • You receive Social Security disability benefits
  • You receive Railroad Retirement board (RRB) disability benefits
  • You suffer from end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease)

Keep in mind, you will be eligible for Medicare Part B benefits only after 24 consecutive months of receiving Social Security or RRB disability benefits.

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When Can I Enroll in Medicare Part B?

If you’re enrolling in Medicare for the first time, you can enroll during your Initial Enrollment Period (IEP). Your Initial Enrollment Period begins three months before the month of your 65th birthday and ends three months after your birth month.

If you’re already on Original Medicare and want to enroll in an Medicare Advantage plan, you can do so during the Annual Enrollment Period (AEP), which starts October 15 and ends December 7 every year.

Under some circumstances, you may be able to enroll in an Medicare Advantage plan during a Special Enrollment Period. For example, if you’ve recently moved or if you’re currently living in a nursing home. Talk to one of our licensed agents today to see if your life circumstance applies.

Call a licensed agent at 1-855-200-9401 | TTY: 711