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Part B (Provider) Cost Details

The chart below shows your estimated part B monthly premium based on your income as reported on your IRS tax return. If your income is above a certain limit, you will pay an income-related monthly adjustment amount in addition to your part B premium.

 If your yearly income in 2019 (for what you pay in 2021) was You pay each month (in 2021)
 File individual tax return File joint tax return File married & separate tax return
 $88,000 or less $176,000 or less $88,000 or less $148.50 
 above $88,000 up to $111,000 above $176,000 up to $222,000 Not applicable $207.90 
 above $111,000 up to $138,000 above $222,000 up to $276,000 Not applicable $297.00 
 above $138,000 up to $165,000 above $276,000 up to $330,000 Not applicable $386.10 
 above $165,000 and less than $500,000 above $330,000 and less than $750,000 above $88,000 and less than $412,000 $475.20 
 $500,000 or above $750,000 and above $412,000 and above $504.90 

Home Health Services

$0 for home health care services

20% of the Medicare-approved amount  for durable medical equipment (DME) 

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 (DME) .

Outpatient mental health services

You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.

20% of the Medicare-approved amount  for visits to your doctor or other health care provider  to diagnose or treat 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 assignment. You also pay coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center, and the Part B deductible applies.

Outpatient Hospital Services

You usually pay 20% of the Medicare-approved amount for the doctor or other health care provider's services. For services that can also be provided in a doctor’s office, you may pay more for outpatient services you get in a hospital than you’ll pay for the same care in a doctor’s office. However, the hospital outpatient copayment for the service is capped at the inpatient deductible amount.

In addition to the amount you pay the doctor, you’ll also usually pay the hospital a copayment for each service you get in a hospital outpatient setting, except for certain preventive services that don’t have a copayment. In most cases, the copayment can’t be more than the Part A hospital stay deductible for each service.

The Part B deductible applies, except for certain preventive services . If you get hospital outpatient services in a critical access hospital, your copayment may be higher and may exceed the Part A hospital stay deductible.

 

 


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