On July 30, 1965, President Lyndon B. Johnson signed into law the bill that led to the Medicare and Medicaid. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance)The U.S. Government’s Medicare Part B is a program used mostly in the treatment and prevention of illness.
In the African American community, Medicare Part B can be used to reduce the incidence of ill health in a population (morbidity). This is especially important since Black Americans have a high incident of diseases that can be managed1 in a team effort between the patient, doctor and other healthcare professionals.
Heart Disease, Diabetes, Stroke and Kidney Disease patients will benefit from services provided by this program. The great part of Medicare Part B is that it covers many preventative services at low or no cost. Flu shots are considered a preventive service, for example.
“We don’t even know how strong we are until we are forced to bring that hidden strength forward. In times of tragedy, of war, of necessity, people do amazing things. The human capacity for survival and renewal is awesome.” Isabel Allende
Jay Harold urges people who are eligible for the Medicare program to join. This is especially important since private insurance may not be affordable. The Trump Tax Cuts2 may negatively affect the Medicare Program. The Medicare website3 can be used extensively to provide timely and accurate info.
2017
The standard Part B premium amount in 2017 is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount. This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits. If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average). Social Security will tell you the exact amount you’ll pay for Part B in 2017. You’ll pay the standard premium amount (or higher) if:
- You enroll in Part B for the first time in 2017.
- You don’t get Social Security benefits.
- You’re directly billed for your Part B premiums (meaning they aren’t taken out of your Social Security benefits).
- You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.)
- Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
If you’re in 1 of these 5 groups, here’s what you’ll pay:
| If your yearly income in 2015 (for what you pay in 2017) was | You pay each month (in 2017) | ||
|---|---|---|---|
| File individual tax return | File joint tax return | File married & separate tax return | |
| $85,000 or less | $170,000 or less | $85,000 or less | $134 |
| above $85,000 up to $107,000 | above $170,000 up to $214,000 | Not applicable | $187.50 |
| above $107,000 up to $160,000 | above $214,000 up to $320,000 | Not applicable | $267.90 |
| above $160,000 up to $214,000 | above $320,000 up to $428,000 | above $85,000 and up to $129,000 | $348.30 |
| above $214,000 | above $428,000 | above $129,000 | $428.60 |
2018
The standard Part B premium amount in 2018 will be $134 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount ($130 on average). You’ll pay the standard premium amount (or higher) if:
- You enroll in Part B for the first time in 2018.
- You don’t get Social Security benefits.
- You’re directly billed for your Part B premiums (meaning they aren’t taken out of your Social Security benefits).
- You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $134.)
- Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
If you’re in 1 of these 5 groups, here’s what you’ll pay:
| If your yearly income in 2016 (for what you pay in 2018) was | You pay each month (in 2018) | ||
|---|---|---|---|
| File individual tax return | File joint tax return | File married & separate tax return | |
| $85,000 or less | $170,000 or less | $85,000 or less | $134 |
| above $85,000 up to $107,000 | above $170,000 up to $214,000 | Not applicable | $187.50 |
| above $107,000 up to $133,500 | above $214,000 up to $267,000 | Not applicable | $267.90 |
| above $133,500 up to $160,000 | above $267,000 up to $320,000 | Not applicable | $348.30 |
| above $160,000 | above $320,000 | above $85,000 | $428.60 |
Medicare Premiums: Rules For Higher-Income Beneficiaries4
Late enrollment penalty for Part B5 :
In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B. Coverage will start July 1 of that year.
Part B costs if you have Original Medicare
All Medicare Advantage Plans must cover these services. If you’re in a Medicare Advantage Plan, costs vary by plan and may be either higher or lower than those in Original Medicare. Review the “Evidence of Coverage” from your plan.
- Part B annual deductible: You pay $183 per year for your Part B deductible ($183 in 2018). After your deductible is met, you typically pay 20% of the Medicare-approved amount for these:
- Most doctor services (including most doctor services while you’re a hospital inpatient)
- Outpatient therapy
- Durable medical equipment
- Clinical laboratory services:
You pay $0 for Medicare-approved services.
- Home health services:
- $0 for home health care services.
- 20% of the Medicare-approved amount for durable medical equipment.
- Medical and other services:
You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
In 2017 and 2018, there may be limits on physical therapy, occupational therapy, and speech-language pathology services. If so, there may be exceptions to these limits.
- Outpatient mental health services:
- You pay nothing for your yearly depression screening if your doctor or health care provider accepts an assignment.
- 20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose or tre
at your condition. The Part B deductible applies. - If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.
- Partial hospitalization mental health services:
You pay a percentage of the Medicare-approved amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts an assignment. You also pay coinsurance for each day of partial hospitalization services provided in a hospital outpatient setting or community mental health center, and the Part B deductible applies.
Outpatient hospital services:
- You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider’s services, and the Part B deductible applies.
- For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor’s office.
- For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don’t apply (so you pay nothing).
Medicare Part B plays a vital role in the health of many Americans. Please take the time to review and sign up for the program if eligible.
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Bibliography
- https://www.healthcare.com/blog/top-health-concerns-among-african-americans/
- https://www.washingtonpost.com/news/wonk/wp/2017/12/01/gop-eyes-post-tax-cut-changes-to-welfare-medicare-and-social-security/?utm_term=.3fcd3cd8a1ca
- https://www.medicare.gov/
- http://socialsecurity.gov/pubs/EN-05-10536.pdf
- https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html
