Medicare Part B. What does it cover? Do you need Medicare Part B? If you don’t buy Medicare Part B what is my exposure? Can you buy a Medigap plan if you don’t have Part B? Are you turning 65? 
Medicare Part B is thought of as covering doctor visits. Truth is, Part B covers much more than just a visit to the doctor.
Part B covers outpatient doctor services including office visits.
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Medicare Part B Durable Medical Equipment
Most durable medical equipment (DME) is covered under Medicare Part B. Medically necessary medical equipment can be purchased or rented from an approved Medicare DME provider.
Not all DME is covered by Medicare {art B. Before Medicare will pay for your durable medical equipment it must meet the following criteria.
- The equipment cannot be designed solely for single use
- Your DME must be medically necessary and serve a specific medical purpose
- The equipment should be designed to last 3 or more years
- They equipment must be distributed by an approved Medicare DME supplier
Examples of DME covered by Medicare include oxygen equipment, wheelchairs, walkers, hospital beds and scooters . . . but not hearing aids.
Most preventive services, including those available at no charge to you, are covered under your Part B benefits.
Outpatient services, such as speech or physical therapy are included in your Part B benefits.
Some services by medical transport companies (ambulance) are included in Part B.
Medically necessary spinal manipulation as performed by a chiropractor is a Part B covered item.
Some outpatient psychiatric care, including group and individual counseling or therapy is covered by Medicare Part B.
X-rays, CT scans, MRI, PET and lab tests are included in your Part B benefit package.
Home health services and medically necessary services provided by a skilled nursing facility (SNF) are part of your Medicare Part B coverage.
Most drugs are paid by your Medicare Part D, but drugs administered in a clinical setting, such as chemotherapy, are included in Medicare Part B.
Other Part B Covered Expenses
Sleep apnea may require the use of a CPAP machine. But not all machines are eligible and some DME providers are not approved by Medicare.
Diabetic insulin is normally a Part D covered item. But if you have a pump your insulin may be a Medicare Part B covered item.
Lower Out of Pocket Costs
Most people fear huge hospital bills. When you have original Medicare your OOP (out of pocket) for most hospital charges is limited to your deductible.
Huge medical bills running $20,000 and more are usually incurred as outpatient Part B expenses. Unlike health insurance you had in the past there is no OOP limit. Medicare pays 80% of approved charges after your calendar year deductible. You are responsible for the remaining 20%.
There is no cap.
You continue paying until you get well, run out of money or die.
Medicare supplement plans F and G limit your Part B exposure to less than $200 in 2017. For a few dollars a day in Medigap premiums you can have peace of mind.
There are more than 170 different approved Medicare supplement plans in Georgia. Which one is right for you?
Give us a call. We are glad to help.
Georgia Medicare Plans has affordable Medigap rates for seniors on Medicare Part A and Part B.
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