Resources > Medicare Part B
Medicare Part B covers various outpatient medical services and other doctor services. Part B is a voluntary program and Medicare-eligible individuals must enroll in Medicare Part B in order to receive the programs benefits.
Medicare Part B covered services are reimbursed at 80% of the “reasonable charge” for the service. The individual receiving the service is responsible for paying the remaining 20%. However, this reasonable charge is determined by Medicare and may not adequately reflect the costs you pay to your physician.
When a doctor agrees to accept the Medicare-set “reasonable charge” as full payment, he or she is said to accept “assignment.” When a doctor does not accept “assignment,” the patient is responsible for paying the outstanding balance minus the Medicare-determined reimbursement. However, federal law sets a limit as to the maximum amount a doctor may bill for a service.
The maximum amount to be billed for a Medicare Part B covered service is 115% of the Medicare “reasonable charge.” If the doctor bills above this cap, he or she violates federal law.
The monthly premium for Medicare Part B can change annually. It is common for enrollees to have their Part B premium deducted from their Social Security check.
| If your yearly income in 2015 (for what you pay in 2017) was: | You pay: | |
|---|---|---|
| File individual tax return | File joint tax return | |
| $85,000 or less | $170,000 or less | $134.00 |
| $85,000 to $107,000 | $170,000 to $214,000 | $187.50 |
| $107,000 to $160,000 | $214,000 to $320,000 | $267.90 |
| $160,000 to $214,000 | $320,000 to $428,000 | $348.30 |
| $214,000 | above $428,000 | $428.60 |
Get more information about your Plan B premium from Social Security.