Medicare Part B covers non-hospital charges, such as physician and outpatient services.
Medicare is the U.S. government health insurance program for retirees and those covered by Social Security disability. The two main parts of Medicare are Part A, hospital insurance, and Part B, which covers doctor charges and outpatient medical services. Medicare determines the deductibles and coinsurance amounts by a schedule of services and which part covers the specific service.
Medicare Part B Services
The Medicare Handbook provides an extensive list of medical services that are covered by Part B. Some of the listed services include ambulance service, outpatient surgery centers, laboratory services, cancer screenings. diabetes screenings and supplies, doctor services, home health services and medical equipment. Medicare will pay the providers a pre-determined rate for Part B listed services.
Part B Deductible and Copayments
For 2011, the deductible for Part B Medicare was $162. The deductible is adjusted each year. For example, in 2010 the Part B deductible was $155. After the annual Part B deductible has been paid, Medicare participants are responsible for a coinsurance of 20 percent of any Part B covered medical charges. Medicare pays 80 percent of covered medical services after the deductible amount has been paid by the Medicare participant. There is no limit to the amount that can be paid under the 20 percent coinsurance.
Free Preventative Services
According to the Medicare Handbook, starting on Jan. 1, 2011, Medicare made many preventative services free of charge. These services would be exempt from the payment of the annual deductible or 20 percent coinsurance. Preventative services include cancer screenings, flu shots, glaucoma tests. smoking cessation counseling and physical exams. The Handbook notes there may be a 20 percent coinsurance charge for a doctor's office visit to receive preventative care.
Medigap Insurance
Medicare participants have options for additional coverage to help pay for the Medicare deductibles and coinsurance. Part C, Medicare Advantage plans involve enrolling in a participating PPO or HMO that provides covered Medicare services. A medigap insurance policy is offered by private insurance companies and pays the portion of medical costs not covered by Medicare.
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