Medicare Part B is a component of Medicare, a federal health insurance program for elderly and disabled Americans. Part B is available nationwide at the same price with the same basic benefits. However, some options are state-specific and work a little differently in Georgia.
Benefits
Medicare Part B primarily covers services that you would receive in a doctor's office, or outpatient services. Some of these services include preventive care (such as cancer screenings or diabetes screenings); therapy services such as physical, speech and occupational therapy; three pints of blood; laboratory work and x-rays; home health services; and durable medical equipment. Most services that are medical that do not take place overnight in a hospital will more than likely fall under Part B. Some prescription drugs that are administered by a doctor are also under Part B, rather than the Medicare drug benefit.
Costs
If you have original Medicare, then you will be charged a monthly premium to access your Part B benefit. Additionally, you will also have to meet an annual deductible, and you will pay a coinsurance of 20 percent for all services, except in the case of mental health services, which are 45 percent. However, this copayment will decrease to 20 percent by 2014 per the mental health parity law changes passed in 2010.
Medicare Advantage
Georgia has a selection of Medicare Advantage plans that is different from other states. Medicare Advantage is Part C of Medicare, wherein you get the option to choose to receive your Medicare benefits through a private health plan. Part B benefits would come packaged in a health insurance plan that also includes your Part A (hospital) benefits.
According to Medicare.gov's Planfinder, someone in Georgia with average health can expect Medicare Advantage plans to be as low as $3,000 annually, or as expensive as $6,000. The health plan quality is rated on average 2.5 out of 5 stars. Private Fee-for-Service, HMOs, and Preferred Provider Organizations are the top three types of Medicare Advantage plans available.
Medigaps
If Medicare enrollees receive Part B benefits through original Medicare, then they may purchase supplemental insurance that wraps around their Part B benefits, called Medigaps. These plans each supply different benefits, but typically cover deductibles, coinsurances and additional hospital days, and they may pay for services that original Medicare does not cover.
There are 38 agencies that sell Medigap policies in Georgia, and plans A to L are available in the state. However, not all plans are available in all areas of Georgia.
Low-income Assistance
For Georgians with low incomes, there are Medicare Savings Programs (MSPs) available that can help pay for some of the costs of Part B. There are three levels of MSPs: Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB) and Qualifying Individual Program (QI).
QMB enrollees get help paying their Part A and B premiums, deductibles and coinsurance. SLMB and QI recipients get their Part B premium paid for. Eligibility is based on 100 percent, 120 percent and 135 percent of the federal poverty level, respectively.
MSPs are administered by Medicaid in Georgia.
Tags: Medicare Advantage, Advantage plans, Medicare Advantage plans, Medicare Part, original Medicare, Part benefits
