Help! I’m Losing Dental Benefits with My Employer and Enrolling in Medicare!
Does Medicare provide dental coverage? Does Medicare provide coverage for eyeglasses? What’s NOT covered by Medicare Part A and Part B? If you’re on the hunt for the answers to these questions, you won’t want to miss this episode of Medicare Moments!
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What is Medicare Part B?
Medicare Part B is a federal health insurance program that covers medically necessary services (such as doctor’s visits, lab tests, and preventative services) and some medical equipment. Part B is optional, unlike Part A (hospital insurance), which is generally free if you or your spouse has worked and paid into Medicare for 10 years. Part B requires that beneficiaries pay a monthly premium, which is based on income. For most beneficiaries, the standard premium is $164.90 per month in 2023.
What Does Medicare Part B Cover?
Medicare Part B covers a wide range of healthcare services, including doctor’s office visits, medical testing, durable medical equipment, and more. Before seeing any healthcare provider, it’s important to make sure they accept Medicare Assignment and take Medicare Part B. Here are some of the services and supplies you can expect to be covered under Part B:
- Doctor visits – Part B covers visits to doctors and other health care professionals, including nurse practitioners and physician assistants.
- Preventive care – Part B covers preventive services such as screenings for cancer, diabetes, and heart disease, as well as flu shots and other vaccines.
- Lab tests – Part B covers medically necessary lab tests, including blood tests, urine tests, and X-rays.
- Durable medical equipment – Equipment that your doctor prescribes for use at home, such as walkers, wheelchairs, and oxygen equipment are included.
- Outpatient surgeries – These are procedures that don’t require an overnight stay in the hospital.
- Ambulance services – Ambulance services are covered when other transportation could endanger your health.
What Does Medicare Part B NOT Cover?
While Medicare Part B covers many medical services and supplies, it does not cover everything. Here are some of the services and supplies that are not covered:
- Dental care – Part B does not cover routine dental care such as teeth cleanings and fillings.
- Vision care – Routine eye exams, eyeglasses, and contact lenses are all uncovered expenses.
- Hearing aids and exams – This also includes hearing aid fittings and OTC hearing aids.
- Long-term care – Part B does not cover long-term care such as nursing homes.
- Cosmetic surgery – Part B does not cover cosmetic surgery unless it’s medically necessary.
What are the out-of-pocket costs?
While Medicare Part B covers a lot, you may have to pay out of pocket for some services or supplies. In addition to the monthly premium, here are some of the out-of-pocket costs you might expect:
- Deductible – You must pay the Part B deductible ($226 in 2023) before Medicare starts paying for your medical services.
- Copayments and coinsurance – After you meet the deductible, you may still be responsible for copayments or coinsurance for certain services.
- Excess charges – If your doctor charges more than the Medicare-approved amount for a service, you may have to pay the excess charge out-of-pocket.
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Originally published April 24, 2024
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