Dynamic Duo: Medicare Part B

Allie explains the basic coverage under Medicare Part B

We’re back here with the Dynamic Duo with me, Allie Shipman, and John Shinn, my partner. Today, we’re going to talk about original Medicare Part B and how you, the agent, can more simply explain it to your clients. Basically, Medicare Part B covers doctors’ visits, outpatient surgery, and other services. There is an annual deductible of $183. After the Deductible, Medicare will pay for 80% of eligible charges, and your client will pay the remaining 20%.

Other services include medically necessary services and supplies, needed to diagnose or treat your medical condition; these service must meet the accepted standards of medical practice. In addition, Part B covers preventative services, including health care to prevent illness like flu or detect it an early stage when treatment is most likely to work best. Part B also cover things like clinical research, ambulance services, durable medical equipment, and mental health services, such as inpatient and outpatient with partial hospitalization. It covers getting a second opinion before a surgery and limited outpatient prescription drugs. All of this information can be found on Medicare.gov. Please refer to the that website for much more information about Medicare.

John Shinn talks more in depth about Medicare Part B

Every agent should know how Part B works. Part B as you know is the part of original Medicare that pays for doctor visits, outpatient visits, and really anything outside the hospital. Part A covers the hospital part, while Part B covers the doctors and medical services provided outside. As previously mentioned, Medicare pays 80% of eligible and approved charges, and then the client pays the remaining 20%. That happens after paying the Part B deductible, which is an annual deductible. This is different from the Part A deductible which is per benefit period.

So, you need to know that there’s a Part B deductible which is paid annually. Then, the client pays 20% of all the eligible and approved charges that are not paid for by Medicare. Those are the highlights, and if you want to know more about this, go to Medicare.gov and download the Medicare & You 2017 guide. It goes into great detail, and it is the official guide to Medicare. It explains Part A and Part B. If you want to know more about that, you can do it right there. Thanks for watching I hope that helps.


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