What Does Medicare Part B Cover?
It includes two primary parts:
- Medically-necessary services – medical services or supplies doctors or nurses need to diagnose or treat your medical condition
- Preventative services – early detection testing, screenings, vaccines* like flu shots, illness prevention
*Part D, instead of Part B, may cover some vaccines like the shingles vaccine.
A few more things that Part B covers:
- Doctor visits (primary or specialist)
- Specific cancer screenings
- Some lab tests
- Annual check-up with your primary physician
- Clinical research
- Diabetes screening, supplies, and diabetes services and prevention program
- Screening and counseling for alcohol abuse
- Vaccines like flu and pneumonia
- Depression screenings
- Mental health inpatient and outpatient treatment
- Second opinions for surgical recommendations
- Ambulance services
- Durable medical equipment
How Do I Know if Medicare Covers My Needs?
First, talk with your doctor. Let him or her know that you are starting Medicare and ask if Medicare covers the services and supplies you need.
Second, check with Medicare to find out if your medical needs are covered. Visit their website, enter the name of the test, item, or service. Medicare's website will tell you if it is covered, how much you would pay, and any instructions to provide your health care professional.
Three factors determine Medicare coverage:
- Medicare's decisions about whether something is covered
- Local insurance companies deciding what to cover and whether something is medically necessary
- Laws of each state and the federal government
Which Screenings Does Medicare Cover?
- Abdominal aortic aneurysm
- Alcohol misuse & counseling
- Bone mass measurements (bone density)
- Cardiovascular disease
- Cardiovascular disease (behavioral therapy)
- Cervical & vaginal cancer
- Colorectal cancer
- Multi-target stool DNA tests
- Screening barium enemas
- Screening colonoscopies
- Screening fecal occult blood tests
- Screening flexible sigmoidoscopies
- Diabetes self-management training
- Glaucoma tests
- Hepatitis B Virus (HBV) infection
- Hepatitis C test
- Lung cancer
- Nutrition therapy
- Obesity screenings & counseling
- One-time "Welcome to Medicare" preventive visit
- Prostate cancer
- Sexually transmitted diseases & counseling
- Shots: Flu shots, Hepatitis B shots, Pneumococcal shots
- Tobacco use cessation counseling
- Yearly "Wellness" visit
What Does the Yearly Wellness Visit Include?
First, you will fill out a risk assessment questionnaire that gives your health care provider an overview of your current status. You can also write down any concerns or questions you want to talk about with the doctor.
Then, the doctor will meet with you and
- Check your height, weight, blood pressure, and other routine measurements.
- Discuss your medical and family history
- Review your current list of providers and prescriptions
- Go over risk factors and treatment available options
- Screen for Alzheimer's disease or dementia
- Set up a screening schedule for preventative services
- Provide personalized health advice
- Talk about advance care planning if you become incapacitated
How Much Does Medicare Part B Cost?
Medicare Part B requires that you pay a monthly premium. They automatically deduct it from your Social Security check, or you will receive a bill in the mail.
The cost of Medicare Part B depends on your tax information reported two years back.
In addition to a monthly premium, you'd pay a $198 annual deductible. After that, you would pay 20% of the Medicare-approved amount for doctor's services, outpatient therapy, and durable medical devices.
Unfortunately, Medicare does not cap the maximum amount you would pay out of pocket. You could end up paying it endlessly. If you had a critical health event, the coinsurance could bankrupt your family.
If you purchase a Medicare supplement or Medicare Advantage plan, it will provide additional coverage, close coverage gaps, and cap the amount you pay out-of-pocket. You can enroll in these plans at certain times of the year.
Where Can I Buy Medicare Coverage?
AARDY is the nation's fastest Medicare insurance marketplace. You can compare Medicare supplements and Medicare Advantage plans to find the one that best fits your needs.