Thursday 24 August 2017

Understanding What You Can Expect From Medicare Part B Coverage

By Ruth Robinson


When you get close to retirement age, you will have a lot of decisions to make. Many prefer to work as long a possible, and others have no other choice. If your children are grown and gone, you might consider downsizing your living accommodations. Some lucky individuals have the means to travel. Once you reach sixty-five, you will most likely qualify for Medicare. You have several choices here as well. You can opt for only Part A. If you decide you need more than this offers, you have the option of selecting Medicare Part B coverage in addition to A.

B is not free, doesn't pay one hundred percent for most things, and is not available for all medical needs. If you want both parts, the Social Security Administration will take a portion out of your monthly check to cover them. The amount can vary from year to year. It only covers about eighty percent of allowable procedures and doctor's visits. You are responsible for the rest. There is an annual deductible you have to pay before the program kicks in at all.

Your benefits are based on two things, one of which is medical necessity. This allows participants to seek a diagnosis for a particular condition and get the treatment needed to relieve it. Unlike Plan A, this insurance does not require hospitalization to approve procedures. It surprises many to learn that clinical studies are covered with this plan. It will pay for hospital stays, surgery, and some types of after care.

The preventative side of the program is one of its best attributes. It is common for people who don't have adequate insurance to forgo screening for cancer or make appointments for annual physical exams. With this program seniors can get cervical and breast cancer screenings, annual flu shots, and a wellness visit to their primary physician either free or for an affordable co-pay.

Calling an ambulance may be a necessity, but it can also be expensive if you don't have insurance to cover it. Medicare will pay for an emergency vehicle to pick you up and take you to the closest facility that can treat you. If you want to go somewhere else, there may be out of the pocket expenses for you.

Seniors with mental health issues can get doctor's visits and other outpatient visits paid for. Inpatient and hospital care is also covered under both sections A and B. It won't pay for private nurses, private rooms, personal items like socks and razors, or a phone or television in your room.

Prescriptions are generally not covered by this program. There are exceptions that include some drugs infused through equipment, antigens, and some injections for renal failure. It will cover second opinions before surgery. It will also pay for some medical equipment like manual wheelchairs, crutches, walkers, commode chairs, canes, and hospital beds.

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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