Part B of Medicare is considered medical insurance and is the most similar to traditional health insurance. Part B covers outpatient services and medical services, as well as preventive services and other necessary medical interventions.
What Part B of Medicare Covers
Part B of Medicare covers outpatient services and medical services, some of which are subject to deductibles and copayment, but many are free.
Preventive Services
Preventive healthcare services are usually free if you see a doctor or healthcare provider who accepts assignments. This means they will accept the amounts approved by Medicare as full payment. These services include:
- Bone density measurements
- Cardiovascular disease screenings
- Breast exams
- Cancer screenings (such as cervical, colon, and prostate cancer)
- Depression screenings
- Diabetes screenings
- Flu vaccinations
- Glaucoma tests if you are considered at risk for the disease
- Annual “wellness” visit
Other Necessary Medical Services
In addition, Part B of Medicare helps cover other services or supplies that are necessary to treat or diagnose a medical condition, including services from doctors or healthcare providers, outpatient care, home health care, and durable medical equipment.
- Ambulance services
- Cardiac rehabilitation
- Part of outpatient chemotherapy
- Implantation of a defibrillator
- Diabetes supplies
- Durable medical equipment such as oxygen equipment, wheelchairs, and walkers
- Some types of necessary home health services
- Dialysis and its supplies
- Physical therapy
- Second surgical opinions
- Tests such as MRI, CT scans, EKG, and CPAP trial for up to three months if you are diagnosed with obstructive sleep apnea
- Laboratory services such as blood tests, urine tests, and tissue sample tests
What Part B of Medicare Does Not Cover
Part B of Medicare does not cover expenses that are covered by other parts of Medicare, such as inpatient care in hospitals, care in skilled nursing facilities, intensive care, and prescription drugs. There are also some types of care that are not covered by other health insurance. Most dental care, including dentures, is not covered by any part of Medicare Parts A and B. Vision screenings related to glasses prescriptions (not due to an illness or problem), cosmetic surgery, hearing aids, hearing aid check-ups, and custodial services are not covered either. Long-term care will not be found as a covered service.
Long-Term Care
Also known as “custodial care,” it is non-medical care related to six daily activities: bathing, dressing, eating, transferring, toileting, and maintaining personal hygiene.
This lack of coverage is not unique to Medicare Parts A and B. Most health insurance plans, including Medigap coverage, do not cover these services, according to the Centers for Medicare & Medicaid Services.
Part A of Medicare covers part of the costs of senior care in skilled nursing facilities, but only as an inpatient and not on a long-term basis. Many individuals require skilled care in nursing facilities due to a disability or illness but do not meet the minimum hospital stay requirements. You cannot rely on Part A or Part B of Medicare to cover the expenses of senior care facilities or long-term care if this is the case.
Medicare Advantage Plans (MA)
Medicare Advantage plans (MA), also known as Part C of Medicare, are health care plans from private companies approved by Medicare.
These plans include Part A and Part B of Medicare and usually also include Part D along with additional benefits missing from Medicare plans. For example, it is common for Medicare Advantage plans to include vision, hearing, and dental services. They may also provide lower out-of-pocket costs for your healthcare with an annual limit on your expenses. However, they typically require the use of in-network doctors.
How
Enrollment in Medicare Part B
Are you ready to enroll in Medicare Part B? Here are the steps you should follow:
Check Your Eligibility
Before enrolling in any part of Medicare, you must be eligible. You typically become eligible three months before you turn sixty. However, you may also be eligible earlier if you are disabled or have ESRD or ALS. Additionally, you must qualify for benefits based on your income or the income of a child, spouse, or parent.
Apply for Medicare
You will have three options for applying when you are eligible if you are not automatically enrolled:
- You can apply for Medicare coverage on your own through the Social Security Administration (SSA).
- You can apply for Social Security benefits.
- You can apply for Railroad Retirement Board (RRB) benefits.
You will be automatically enrolled in free Part A coverage, and you can choose whether you want Part B if you apply for Social Security benefits or RRB benefits.
You can apply for Medicare or Medicare with Social Security benefits on the Social Security Administration website, or by calling Social Security at 1-800-772-1213, or visiting your local Social Security office. If you or your spouse have worked in the railroad industry, you can apply for RRB benefits by calling the Railroad Retirement Board at 1-877-772-5772.
Enrollment is not automatic if you are not eligible for free Part A. You will need to enroll with the Social Security Administration and pay the Part A and Part B premiums during a valid enrollment period.
Enrollment During the Enrollment Period
You can only enroll in Medicare Part B during the initial enrollment period, general enrollment period, or special enrollment period.
- Initial Enrollment Period (IEP): A seven-month period that starts three months before you turn sixty and ends three months after.
- General Enrollment Period: An annual enrollment period that starts on January 1 and ends on March 31. Starting January 1, 2023, coverage begins the month after enrollment.
Source: https://www.thebalancemoney.com/medicare-part-b-coverage-facts-4135605
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