What Does Medicare Part B Cover?
A Complete Guide to Medicare Part B
Welcome to Medicare School Daily, where we demystify the complexities of Medicare. Today’s tutorial focuses on an important question – “What does Medicare Part B cover?”
Let’s dive in!
What is Medicare Part B?
We’ve previously discussed Medicare Part A, which is essentially the ‘inpatient side’ of Medicare, covering hospitalization insurance. Part B, on the other hand, is the ‘outpatient side’ of Medicare, also referred to as medical insurance. Our focus today is to clarify what Medicare Part B coverage entails.
Outpatient Treatment Coverage: Lab Tests and Scans
First off, Part B caters to all outpatient services. This includes laboratory tests like blood work and imaging scans such as CAT scans, MRIs, and PET scans. For instance, if you require outpatient surgery, perhaps a knee replacement or gallbladder removal, these medical procedures fall under the coverage of Medicare Part B.
Doctor's Consultations
Secondly, Medicare Part B covers all doctor or specialist consultations you may need. Whether the physician visits you in the hospital or you visit them at their office, their payment is through Medicare Part B. This coverage spans from primary care doctors to ER doctors and from surgeons to anesthesiologists.
“In other words, all doctors are paid through Medicare Part B.”
Durable Medical Equipment (DME)
Thirdly, Part B caters to what’s called Durable Medical Equipment (DME). The extensive list of DME includes, but is not limited to, CPAP machines for sleep apnea patients, insulin pumps and supplies for diabetes, oxygen supplies, wheelchairs, and walkers for movement limitations, and medically necessary beds in the home.
Home Health Care
Home health care is also covered under Part B, especially after an outpatient procedure like a knee surgery done in an Ambulatory Surgical Center. Medicare Part B continues to cover the cost of home health care for such cases. It’s important to note that home health care may also fall under Medicare Part A, depending on where the health care service started.
Professionally Administered Medications
Medications that need professional administration are also covered by Medicare Part B. These include infusions, certain injections, and medications processed through durable medical equipment devices. For example, if you’re a diabetic using an insulin pump, the insulin is covered by Medicare Part B.
Certain expensive medications like Prolia, used to treat osteoporosis, are also covered under Part B. This is beneficial because of the high cost associated with these kinds of medications.
The key to identifying which medications are covered is in their method of administration. If the medication is ‘professionally administered’, it is covered.
Preventive Services
Lastly, Medicare Part B covers preventive services to maintain the optimal health of patients. For both men and women, preventive services are covered at 100%. Always ensure that the preventive treatment you opt for is covered by Medicare to avoid incurring unexpected medical costs.
Here’s an example: preventive vaccinations like flu shots, pneumonia shots, COVID-19 shots, and hepatitis B shots are all covered. From January 2023, this list was expanded to include any imposing adult immunization and shingle shots.
“One important point to note – preventive services are the only items covered 100% by Medicare Part B.”
While Medicare Part B provides a comprehensive coverage for outpatient services, some costs may still apply. Stay tuned for our next blog post to understand these costs to avoid unexpected expenses.
Thank you for joining us in today’s exploration of Medicare Part B! At Medicare School Daily, we aim to make health insurance less intimidating and easier to navigate – one tutorial at a time.
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