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Q: How Does Medicare Part B Work?

Hal Levy October 12, 2017

Medicare Part B is the component of Medicare that covers your preventative care and doctor visits. Medicare also places outpatient surgery, laboratory work, and medical equipment under the Part B umbrella.

If you’re not dealing with an immediate medical emergency or buying prescription drugs, then your health issues will probably be taken care of by Part B. The most common components of part B include:

  • Physician Visits: Doctor’s appointments are generally covered by Part B. There’s no limit to the number of medically necessary visits you can schedule. Part B also covers x-rays, urine samples, and blood work.
  • Outpatient Surgery: Same-day surgeries are covered by Part B. Longer hospital stays are covered by Part A.
  • Screenings: Part B covers the entire cost of screening visits for dozens of common medical conditions. You’re also entitled to receive a full wellness checkup once per year, free of charge.
  • Flu Shots and Vaccines: Flu shots, pneumococcal shots and hepatitis B shots are covered by Part B with no copayment.
  • Some Prescriptions: While you can’t rely on Part B to cover most prescription drugs outside of the hospital, certain lifesaving drugs for chronic conditions – like diabetes, hemophilia, and organ transplants – are covered by Part B.
  • Counseling Services: Counseling and therapy sessions are covered by Part B.
  • Medical Equipment: Durable medical equipment will be covered by Part B if it comes with a doctor’s prescription. Part B can pay for canes, commode chairs, glucose monitors, hospital bed, walkers, or other homecare devices.
  • Ambulance Services: Part B will cover your ambulance costs when you’ve had a sudden medical emergency or cannot be transported safely by other means. However, Part B does not cover medical transportation for routine care.

Part B generally doesn’t cover long-term care, hearing aids, glasses, or dental work.

Medicare Part B (along with Part A) makes up “Original Medicare”, which is provided by the federal government. Most doctors take Part B, and nearly all eligible American seniors are enrolled in Original Medicare.

Cost of Medicare Part B

The standard Medicare Part B premium in 2017 is $134 per month for new beneficiaries. Medicare sends a bill every 3 months. If your income as reported two years ago was over $85,000 ($170,000 if filing jointly), then you’ll pay a little more this year.

Part B enrollees pay a deductible of $183 per year. If you only have Original Medicare, you’ll be responsible for paying 20 percent of your medical costs once your deductible is reached. However, Medigap plans can cover these charges for you.

Next Steps to Take:

Prepare to enroll in Medicare as early as possible by reading our Medicare guides. Once you sign up for Medicare Part A and Part B, you can enroll in the Medicare Supplement plan of your choice from HealthCare.com.

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