Understanding What You Can Expect From Medicare Part B Coverage

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By Ruth Robinson


Some people really look forward to retirement. They make plans to travel or sell their homes and move into something smaller and more efficient. While there are plenty of individuals who have no plans to quit their jobs, others are anxious to have more free time. This is also a time when some health care decisions have to be made. At sixty-five most Americans qualify for Medicare. Some choose only the free Part A, and others are willing to have a portion of their monthly Social Security set aside to include Medicare Part B coverage.

The benefits included in B are not free. They don't normally cover one hundred percent of medical costs, and there are plenty of procedures the benefits don't cover at all. Social Security automatically takes the required amount you owe out of your monthly check. You have to pay the deductible at the beginning of each year. Part B only pays eighty percent of your total bill for approved medical services. You will need supplemental insurance to cover the other twenty percent or pay it out of your pocket.

Your benefits include what is considered medically necessary. This covers the services and materials needed to diagnose your condition and to treat it. It doesn't require hospitalization in order to pay for these services. Many people don't realize that if they enter a clinical research study, Medicare will pay hospital bills, required surgeries, and treatment for side effects and complications.

One of the great benefits of this section of the program is that it pays for preventive procedures. A lot of people, who either don't have insurance at all or are under insured, put off things like wellness doctor visits, flu shots, and breast exams. Once you reach sixty-five, these necessary procedures become more affordable.

Calling for emergency services can save lives, but it is expensive for those without insurance. Plan B will pay for an ambulance to pick up a patient and take that person to the closest facility with adequate services to assist in the emergency. Patients who want to be taken to specific facilities, especially if they are farther away, will have to pay a portion of the expense.

Senior citizens with mental health problems will have coverage under this plan. It will pay for outpatient care as well as inpatient or temporary hospital care. This is covered under both Part A and B. What is doesn't pay for are personal items such as socks and razors, private rooms, private nurses, a television, or a land line phone in your room.

Drugs are not normally paid for under this program. It does make some exceptions though. Certain renal failure medications, antigens, and medications infused through equipment may be covered. If your primary physician recommends surgery, and you want a second opinion, Part B will cover it. Canes, hospital beds, wheelchairs, commode chairs, and crutches are covered under the plan.

What medical benefits you choose to receive will probably depend on the insurance you already have and what you can afford. You should remember that the services offered through Medicare are limited, and most are not free. Supplemental and long term care insurance are private options you may need.




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