Medicare Part B Costs

Your share of Part B costs includes a monthly premium, an annual deductible and coinsurance for most services. Medicare sets the amount for each of these every year.

Medicare also decides how much it is willing to pay for specific medical services and procedures. The amount Part B will pay is called the Medicare-approved amountThe amount Medicare determines to be reasonable for a covered service. Providers who “accept assignment” agree to accept this amount as payment in full. Providers who accept Medicare but not assignment can charge up to 15% above this amount.. Your Part B coinsurance is based on the Medicare-approved amount.

There are no limits on your out-of-pocket spending with Part B. Your expenses could be substantial if you have a chronic condition or serious illness.

2013 Part B Costs

Premium

• $104.90 up to $335.70 per month depending on your income and tax filing status

Deductible

• $147 per year

Copayment

• None

Coinsurance

• 20% of the Medicare-approved amount for most covered services
• 20% of the Medicare-approved amount for durable medical equipment, such as a walker or wheelchair
• 35% of the Medicare-approved amount for most outpatient mental health care

*The costs shown are for illustration only. Your actual costs may be different.

*The costs shown are for illustration only. Your actual costs may be different.

Even though Ellen’s doctor doesn’t accept assignment in this case, Medicare still limits the excess charges you must pay to 15% of the Medicare-approved amount. The doctor receives $240. This is less than the usual and customary fees of $300 but more than the Medicare-approved amount.