Part B Supplement to Medicare Coverage

If you have Medicare, you must be enrolled in Parts A and B. Part B has a standard rate for most of those insured, but if your modified adjusted gross income per your tax return from 2 years ago is above a pre-set amount, you may have to pay more. Social Security (SS) will do this calculation in order to figure your premium cost, but basically, your modified adjusted gross income is your tax exempt interest income added to your taxable income. Social Security will notify you if you are required to pay more for your Part B benefits. If you disagree, call the SSA at 1-800-772-1213. Also be aware that if you do not sign up for Part B when you are first eligible, you may have to pay a late enrollment fee.

You are eligible for Part B coverage:

When you start receiving Social Security benefits or benefits from the RRB (Railroad Retirement Board). For most people, automatic coverage starts the first day of the month that you turn 65. For those whose birthdays fall on the first of the month, part B will be in place the first day of the month prior to your 65th birthday.If you become disabled under the age of 65 you will automatically get Part B coverage once you have received SS or RRB benefits for a period of 24 months. You will either get your Medicare card in the mail about 3 months before your 65th birthday or at the beginning of the 25th month of your disability.If you are diagnosed with ALS (Amyotrophic Lateral Sclerosis), a.k.a. Lou Gehrig 's disease, you will automatically be enrolled in Part B on the first month that your disability begins.

Part B covers medically necessary services that are required in order to diagnose or treat a medical condition. These services must almost meet the accepted standards of medical practice. If the service is considered 'experimental' or is not an accepted standard, your claim will not be allowed. It is your doctor's or the testing facility's responsibility to inform you if either of these conditions are present for a procedure or testing.

Part B also covers many preventive services. These services have been proven to either prevent an illness or to detect it at an earlier stage, when treatment is more likely to be successful.

Some of the preventive services covered include:

Abdominal Aortic Aneurysm ScreeningBone Mass MeasurementCardiovascular ScreeningsColon Cancer ScreeningDiabetes ScreeningsSelf-Management Diabetes TrainingEKG ScreeningFlu ShotsGlaucoma TestsHepatitis B ShotsHIV ScreeningMammogramsNutritional Therapy ServicesPap and Pelvic Exams for Cervical and Vaginal Cancer ScreeningPneumococcal ShotSmoking Cessation CounselingThe "Welcome to Medicare" one-time physical exam

Only some of these will be covered 100% and many of them require a referral, so referring to the Medicare & You Handbook or consulting with the Medicare professionals at your doctor's office is recommended. Also keep in mind that in many cases your deductible must be met before payment will be made by Medicare and that some of these procedures or tests are only allowed so often.

Being well informed is the best way to not only manage your health care needs, but to be fully aware of the costs associated with your medical care. If you live on a fixed income and have trouble being able to afford your medical care, check with your local county health office for alternatives or with your local Department of Human Services or similar entity. Many of the larger drug companies even have programs by which all or part of your RX costs can be covered if you meet certain eligibility requirements.

It certainly doesn't hurt to ask and you may be surprised at the ease with which your health care can be managed.

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