Medicare Part B Simplified

Many people have a difficult time understanding the specifics of Medicare Part B. To help you make your Medicare choices, we’re going to simplify it with some concise explanations. If you go to a medical office to have an outpatient exam or procedure, it is likely covered by Medicare Part B.

What Medicare Part B Covers for Beneficiaries

Medicare Part B is part of the healthcare plan for people receiving Medicare. It is the part of the insurance coverage that can include these outpatient services:

  • Visits to your doctor’s office
  • Kidney dialysis
  • X-rays and other imaging
  • Visits to the emergency room
  • Chemotherapy
  • Durable Medical Equipment (DME)
  • Lab work
  • Occupational and/or physical therapy
  • Counseling
  • Transplants

Medicare Part B also includes most basic preventive services like:

  • Various cancer screenings
  • Cardiovascular disease screenings
  • Screenings for sexually active diseases
  • Screenings for diabetes
  • Screenings for hepatitis B and C
  • Screenings for HIV
  • Various vaccines
  • Bone density (DEXA)

The complete list of coverages by Medicare Part B is extensive, and your insurance carrier will be able to explain all of them to you.

What Medicare Part B Does Not Cover

There are some instances that Medicare Part B will not cover even if you go to a doctor’s office or other medical office. Some things NOT covered by Medicare Part B include:

  • Physical exam
  • Dental
  • Cosmetic surgery
  • Most prescription medication
  • Long-term care
  • Most vision exams, glasses, and/or contacts
  • Hearing aids
  • Acupuncture
  • Massage
  • Cosmetic surgery

Benefits of Medicare Part B

Medicare sometimes covers costs that would ordinarily come out of your pocket. Copayments and deductibles are common benefits of having Medicare Part B as part of your Medicare coverage. Patients who require blood transfusions are covered for three pints with their Medicare Part B regardless of if you are in the hospital or an outpatient.

In the months leading up to choosing your Medicare coverage and possible supplemental insurance, consider signing up for Medicare Part B as soon as possible. It is suggested that you sign up before you reach age 65 1/2. This will allow you to have coverage during the gap period between when the other insurance runs out and your regular Medicare coverage kicks in.

Medicare Part B Eligibility

The list of qualifications for Medicare Part B is short. You generally will need to fall into one or more of the following categories:

  • Have reached at least your 65th birthday
  • Have one or more qualifying disabilities
  • Have end-stage renal disease (ESRD)

If you already have Medicare Part A (the hospitalization portion of the insurance), you will automatically fill the criteria for Medicare Part B eligibility as long as you are a citizen of the United States or have been in the US for at least five years legally.

You are also eligible for Medicare Part B if you collect Social Security regardless of your age.

An insurance broker or your insurance carrier will be able to help you when navigating the ins and outs of Medicare Plan B.