12.6.2 Medicare Part B - Medical Insurance
Medicare Part B is a voluntary program designed to provide supplemental medical insurance (SMI) to cover physician services, medical services and supplies not covered under Part A. Medicare Part B participants pay monthly premiums and are responsible for an annual deductible.* After the deductible, Part B will pay 80% of covered expenses.
*In 2011, the monthly premium amount was set at $96.40 and the annual deductible at $162.00 for those filing individual income tax returns with income levels below $85,000.
Starting in 2006, Part B's deductible was raised simultaneously and in conjunction with the premium rate. For instance, if the premium rate was raised by 5%, the deductible was also raised by 5%.
Premium amounts are adjusted according to income - the more you make, the higher premium payment you will be required to pay. Higher annual premiums are scheduled to be phased in over a five-year period.
Part B provides the following services.
- Outpatient hospital care
- Physicians' and surgeons' services
Covered medical and health services include, but are not limited to, the following.
- X-rays and tests
- Therapy
- Dressings
- Splints
- Casts
- Rental of medical equipment
- Prosthetic devices
Primary Payor and Secondary Payor
If a Medicare participant is also covered under an employer-provided health care plan, the employer-sponsored plan would be considered the primary payor and Medicare the secondary payor.
(See page 323 of the Florida study manual for more detailed information.)
