Medicare part B
Part B of Medicare covers many of the areas that are not covered by Medicare part A. Individuals are qualified to receive part B if they are receiving Social Security disability payments for 24 months, Social Security retirement payments, or if they are entitled to Medicare part A . When your Medicare card is sent, you have the option to deny Medicare B coverage. However, you can enroll in part B during the open enrollment period for no charge or at any other time, if eligible, and by paying a fee. Part B covers physicians’ services, outpatient visits, x-rays , medical equipment and similar services.
1. Physicians’ services;
2. Home Health Care;
3. Services and supplies, including drugs and biologicals which cannot be self-administered, furnished incidental to physicians’ services;
4. Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests;
5. X-ray therapy, radium therapy and radioactive isotope therapy;
6. Surgical dressings, and splints, casts and other devices used for fractures and dislocations;
7. Durable medical equipment;
8. Prosthetic devices;
9. Braces, trusses, artificial limbs and eyes;
10. Ambulance services;
11. Some outpatient and ambulatory surgical services;
12. Some outpatient hospital services;
13. Some physical therapy services;
14. Some occupational therapy;
15. Some outpatient speech therapy;
16. Comprehensive outpatient rehabilitation facility services;
17. Rural health clinic services;
18. Institutional and home dialysis services, supplies and equipment;
19. Ambulatory surgical center services;
20. Antigens and blood clotting factors;
21. Qualified psychologist services;
22. Therapeutic shoes for patients with severe diabetic foot disease;
23. Influenza, Pneumococcal, and Hepatitis B vaccine;
24. Some mammography screening;
25. Some pap smear screening, breast exams, and pelvic exams;
26. Some other preventive services including colorectal cancer screening, Diabetes training tests, bone mass measurements, and prostate cancer screening.
Medicare B does not cover the following services:
1. Services which are not reasonable or necessary;
2. Custodial care;
3. Personal comfort items and services;
4. Care which does not meaningfully contribute to the treatment of illness, injury, or a malformed body member;
5. Prescription drugs which do not require administration by a physician;
6. Routine physical checkups;
7. Eyeglasses or contact lenses in most cases;
8. Eye examinations for the purpose of prescribing, fitting, or changing eyeglasses or contact lenses;
9. Hearing aids and examinations for hearing aids;
10. Immunizations except for influenza, pneumococcal and hepatitis B vaccine;
11. Cosmetic surgery;
12. Most dental services ;
13. Routine foot care
Medicare B covers 80% of medical fees, based on what Medicare considers a "reasonable charge" for a certain service. If there is a discrepancy between a doctor’s fee and the "reasonable charge" the patient is responsible for the difference. However, the provider is not legally allowed to charge more than 115% of the "reasonable charge". The biggest complaint about Medicare B is the out-of-pocket expenses. The monthly premium for part B is based on income and is between $96.40 and $238.40. There is also a $135 deductible, meaning that the patient must pay $135 for services before Medicare will start to cover its 80%.
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