What You Pay for Medicare Part B In 2016


How much do you have to pay in 2016 when you are on Medicare and have to see your doctor or other health care provider?

To be covered by Medicare, you need to make sure that your health care provider accepts Medicare. In case you see a provider that does not accept Medicare, you need to pay 100% of the bill – unless you have some other insurance that covers these costs. If you are enrolled in a Medicare Advantage Plan (such as an HMO or PPO plan) or have Medicare supplemental insurance, you need to check your policy or consult your plan provider to find out exactly which benefits and what part of the costs are covered.

However, even if a medical service or an item you need is covered by Medicare, you will in many instances have to pay your share in form of deductibles, coinsurance, or co-payments. Most preventive services rendered by a doctor or other health care provider who accepts Medicare are covered in full, but there are also preventive services for which you may have to co-pay. Make sure you use your free “Welcome to Medicare” preventive visit that is included in your Part B benefits at no costs to you during the first 12 months after you enroll in Medicare.

Dental costs, hearing aids, cosmetic surgery, health care expenses while you travel and long term care are – among others – never covered by original Medicare.

The Medicare Part B premium for 2016 is not yet published by CMS/Medicare.gov. We will update this post once the new numbers are available.

If you don’t have additional coverage and rely solely on traditional Medicare, you must pay all costs yourself until you meet the annual Part B deductible, which is for 2015 $147, before Medicare kicks in. After your Part B deductible is met, Medicare usually pays up to 80% for a medical service or item, if it is approved by Medicare and the health care provider accepts Medicare. You have to take care of the remaining 20%, which may amount to a substantial amount of money as there is no annual limit for your share of out-of-pocket expenses.

Of course you also have to pay your monthly Part B premium. The standard rate for Part B in 2015 is $104.90, or more if you have a high income. For the detailed rates for higher income, please call 1-800-MEDICARE or visit medicare.gov.

By: Joseph Rosario

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