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Medicare part B Specifics

Medicare part B is known as the “physician coverage” part of Medicare and covers three main groups of people. For most Americans the monthly premium is $104.90 if you worked and paid Medicare taxes for 40 quarters or 10 years and the deductible (see below) is $166.

What does it cover?

Physician Appointments
Immunizations – inquire beforehand because not all are covered
X-rays, Lab Work, Diagnostic Procedures
Ambulatory Surgery Services
Wheelchairs, Walkers and even Scooters (need to be physician ordered)
Complete List (over a 100) on medicare.gov which is listed below

What does it NOT cover?

Dentistry – Most seniors have to buy dental insurance or pay as you go
Glasses or eye exams (unless it is disease related?)
Dentures, cosmetic surgery, acupuncture, hearing aids and fitting them, and routine foot care
Care outside of US (if traveling outside US, you might need temporary coverage). Some Medigap and Medicare Advantage Plans do have some “out of country” coverage.

Action Step: As I stressed with Medicare part A, take the time to sign up for Medicare part B in the 3-month window before you turn 65. If you are collecting SS it will be just deducted from that direct deposit (no bill).

Golden Nugget: A deductible is the $’s that a patient needs to pay before the insurance starts. So with Medicare A, you will need to spend $1,260 in services before it kicks in and then it will pay 80%. So if first hospital bill comes in at $2,000 the first $1,260 is the patient’s responsibility plus 20% of the next $740.

Example: $1,288 + 722 (20%) = $1,430.40 Patient Responsibility