5 Ways to Make the Most of Medicare Part B

Navigating Medicare Part B can be overwhelming; from its coverage to its out-of-pocket costs, it can be easy to get lost in the details. However, we’re here to help you understand! If you’re turning 65 or eligible for Medicare due to a disability, then this guide is for you. Here’s everything you need to know about Part B.

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 $174.70 per month in 2024.

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 ($240 in 2024) 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.

Tips for Making the Most Out of Medicare Part B

Making the most of your Medicare Part B coverage requires understanding what is covered and how to use it effectively. Here are some quick tips to help you maximize your benefits:

1. Schedule your annual wellness visit – Medicare Part B covers annual wellness visits which can help identify potential health issues early on. Be sure to schedule these visits and take advantage of the opportunity to discuss any concerns or questions you have about your health.
2. Take advantage of preventive services – Medicare Part B covers a wide range of preventive services at no cost to you. Get your cancer and diabetes screenings!
3. Understand your out-of-pocket costs – Remember that you’ll always have a monthly premium and you will likely pay a deductible. Be sure to understand what your copays are and how to budget for them. If you’re not sure whether a service is covered – ask!
4. Shop around for healthcare services – Healthcare services can vary in cost depending on where you go. Do some research and shop around to find the best prices for medical treatments, procedures, and prescriptions.
5. Consider supplemental insurance – Many people opt to purchase supplemental insurance plans to help with coverage gaps.

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