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Medicare Part B Eligibility

Medicare Part B is part of Original Medicare. This means that it is provided by the federal government, and you have the opportunity to receive coverage without applying. You are automatically eligible for Part B if:

  • You are receiving or will receive benefits from Social Security or the Railroad Retirement Board (RRB) at least four months before you turn 65.
  • You are under 65 and have received disability benefits from Social Security for 24 months or more.
  • You are under 65 and have received certain disability benefits from the RRB for at least 24 months.

If you do not meet these requirements, you will have to apply for coverage. The general eligibility requirements for Part B include:

  • Age: You must be 65 or Older
  • Health Status: You are suffering from End-Stage Renal Disease (ESRD)
  • Disability: You Have Received Social Security Disability Benefits (SSDB) for at Least 24 Months

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Medicare Part B Cost and Coverage

The cost of Medicare Part B is dependent on several different factors:

  • Monthly Premium: Your monthly premium is based on your IRS tax return and Income Related Monthly Adjustment Amount (IRMAA). The standard monthly premium for 2022 is $170.10.
  • Copayments/Coinsurance: These cost-sharing fees are required for certain services/equipment. The typical rate is 20%, but this is subject to change depending on the service and limited under Medicare.
  • Deductible: This is a yearly fee that must be paid before you can receive coverage. In 2022, the Part B deductible is $233.

Medicare Part B generally covers medically necessary equipment and services, including illness treatment, preventative care, checkups, and screenings. More specifically, it covers:

  • Cardiac Rehabilitation
  • Limited Chiropractic Services
  • Ambulance Services
  • Diabetes Supplies
  • Durable Medical Equipment (DME)
  • Kidney Dialysis Services and Supplies
  • Outpatient Mental Healthcare
  • Physical Therapy
  • And Much More
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