What Does Medicare Part B Cover?
Part B of your Medicare Card will cover necessary visits with your family doctor, specialist, or outpatient care.
There are two major types of services covered under Plan B, which are:
- Necessary Medical Services: Any medical services necessary to treat or diagnose your medical condition, as long as they meet the accepted medical standards.
- Preventive Care Services: Services that are aimed to prevent illness (such as flu vaccines) or uncover health conditions while they are effectively treatable. As long as your care provider accepts assignments, most preventative services will be available to you free of charge.
Part B will cover things such as:
- Doctor Visits
- Seeing your primary care doctor at a medical facility
- Specialists Visits
- Seeing a specialized doctor in certain areas such as a cardiologist or neurologist for an example
- Ambulance services
- Medicare Part B (Medical Insurance) covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health. Medicare may pay for emergency ambulance transportation in an airplane or helicopter to a hospital if you need immediate and rapid ambulance transportation that ground transportation can’t provide.
- Clinical studies
- Clinical research studies (also called clinical trials) test how well different types of medical care work and if they’re safe, like how well a cancer drug works. Clinical research studies may involve diagnostic tests, surgical treatments, medicine, or new types of patient care. They may:
- Study how well new treatments and tests benefit patients
- Compare different treatments for the same condition to see which treatment is better
- Study new ways to use existing treatments
- Durable medical equipment (DME)
Part B covers medically necessary durable medical equipment (DME) if your doctor prescribes it for use in your home.
Durable medical equipment that Medicare covers includes, but isn’t limited to:
- Blood sugar monitors
- Blood sugar test strips
- Commode chairs
- Continuous passive motion devices
- Continuous Positive Airway Pressure (CPAP) devices
- Hospital beds
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Oxygen equipment & accessories
- Patient lifts
- Pressure-reducing support surfaces
- Suction pumps
- Traction equipment
- Wheelchairs & scooters
Only your doctor can prescribe medical equipment for you.
Durable medical equipment meets these criteria:
- Durable (can withstand repeated use)
- Used for a medical reason
- Not usually useful to someone who isn’t sick or injured
- Used in your home
- Generally has an expected lifetime of at least 3 years
- Mental health
- Mental health care services help with conditions like depression and anxiety in either inpatient or outpatient setting. You can get these services either in a general hospital or a psychiatric hospital that only cares for people with mental health conditions or inpatient/outpatient setting.
- Certain outpatient prescription drugs
How Much Does Medicare Part B Cost?
While there are some variations, for most citizens, Part B will cost $144.60 per month in the year 2020. Factors such as your income (IRMAA) or if you have Medicare and Medicaid or receive Extra Help will have an effect on your individual rate.
Is there a deductible for Part B?
If you stay with original Medicare as your primary insurance there is a deductible of $198 for the year 2020 that must be met BEFORE the government pays their 80% for Part B.
If you have a Medicare Supplement/Medigap or Medicare Advantage (Part C) plan the deductible may not apply to you.