Part B Monthly Premium

You pay a Part B premium each month. Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

If Your Yearly Income in 2010 was

File Individual Tax Return                   File Joint Tax Return                           You pay

$85,000 or less                                    $170,000 or less                                 $99.90

above $85,001 up to $107,000            above $170,001 up to $214,000        $139.90

above $107,001 up to $160,000          above $214,001 up to $320,000        $199.80

above $160,001 up to $214,000          above $320,001 up to $428,000        $259.70

above $214,000                                   above $428,000                                $319.70

Part B Services

Services : Part B Deductible
You pay $140 per year.

Services : Blood
You pay : In most cases, the provider gets blood from a blood bank at no charge, and you won’t have to pay for it or replace it. However, you will pay a copayment for the blood processing and handling services for every unit of blood you get, and the Part B deductible applies.

If the provider has to buy blood for you, you must either pay the provider costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.

You pay a copayment for additional units of blood you get as an outpatient (after the first 3), and the Part B deductible applies.

Services : Clinical Laboratory Services
You pay: $0 for Medicare-approved services.

Services : Home Health Services
You pay: $0 for Medicare-approved services. You pay 20% of the Medicare-approved amount for durable medical equipment.

Services : 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.

Services : Mental Health Services
You pay: 40% of the Medicare-approved amount for most outpatient mental health care.

Services : Other Covered Services
You pay: copayment or coinsurance amounts.

Services : Outpatient Hospital Services
You pay: a coinsurance (for doctor services) or a copayment amount for most outpatient hospital services.
The copayment for a single service can’t be more than the amount of the inpatient hospital deductible.

* In 2012, there may be limits on physical therapy, occupational therapy, and speech language pathology services. If so, there may be exceptions to these limits.

Note: All Medicare Advantage Plans must cover these services. Costs vary by plan and may be either higher or lower than those noted above. Review the Evidence of Coverage from your plan.