Medicare Part B

Medicare Part B

Part B covers 2 types of services

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive servicesHealth care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Part B Covers Services such as:

  • Doctor and Specialists visits
  • Inpatient & Outpatient Services
  • Partial Hospitalizations
  • Emergency Room Care
  • Limited outpatient prescription drugs 
  • Ambulance Services
  • Durable medical equipment (DME)
  • Mental health services

2 ways to find out if Medicare covers what you need

  1. Talk to your doctor or other health care provider about why you need certain services or supplies. Ask if Medicare will cover them. You may need something that’s usually covered but your provider thinks that Medicare won’t cover it in your situation. If so, you’ll have to read and sign a notice. The notice says that you may have to pay for the item, service, or supply.
  2. Find out if Medicare covers your item, service, or supply by contacting Medicare.

Medicare coverage is based on 3 main factors 

  1. Federal and state laws.
  2. National coverage decisions made by Medicare about whether something is covered.
  3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

For Information for Part A click here.

To speak to a Medicare Specialist call Mike at (610) 420-6064.