Medicare insurance coverage has been in effect for disabled and retired Americans since 1972. Medicare Part A is automatic medical coverage, while Part B is voluntary and meant to fill the holes left by the first coverage. According to the nonprofit consumer advocacy group Center for Medicare Advocacy, Medicare is a fairly comprehensive insurance policy. At the same time, there are many services that are excluded from the plan.
Qualifications
Medicare part B is the government insurance for retirees, the disabled and people with end-stage kidney failure. People who become eligible for Medicare Part A also may choose Part B coverage. If Medicare eligible recipients don't elect to receive Part B coverage when they first become eligible, they usually must pay higher premiums when they do elect coverage, up 10 percent for every year they refuse the insurance.
Benefits
Services covered under Medicare Part B include outpatient and physician bills, certain home health services and durable medical equipment. Medicare part B also covers other services not insured by Part A, such as physical and occupational therapists. Ambulance services, diagnostic tests, some vaccines, x-rays and some preventive screening tests also are covered by Part B insurance. After the yearly deductible is met, Medicare pays 80 percent of the reasonable charges from doctors and healthcare providers.
Exclusions
Most dental services, hearing aids, eye examinations, glasses and contacts are not covered by Part B Medicare insurance. Personal care items not prescribed by a doctor are not eligible for coverage. Routine physical exams and cosmetic surgery do not fall within the Medicare coverage either. Appeal forms are available online at the U.S. Health and Human Services website for patients who don't agree with a decision made by Medicare.
Costs
Premiums for Medicare Part B are $96.40 per month. There is an annual deductible, in the neighborhood of $100, which is subject to change each year. Single people who earn more than $85,000 per year and married couples earning greater than $170,000 per year may be required to pay higher premiums. The standard premium is a figure based on 25 percent of the average costs of services to Medicare recipients over the age of 65. People in higher earning brackets receive an individual premium that's based on their total income and can go as high as $308.30 per month. In 2009, the first year high-income Part B enrollees paid the full additional amount, nearly 5 percent of Medicare recipients paid higher premiums, reports the Centers for Medicare & Medicaid Services.
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