AARP Hearing Center
Key takeaways
- Understand Medicare Part B coverage with guidance from Tricia Sandiego, a trusted Medicare adviser.
- Access essential services like doctor visits and preventive screenings, often at no out-of-pocket cost.
- Plan for Medicare Part B expenses and explore supplemental coverage for greater financial protection.
Summary
Understanding Medicare Part B coverage is crucial as you approach retirement, since it’s the foundation of your health benefits under Medicare. Tricia Sandiego, a trusted Medicare adviser, explains that Medicare Part B covers essential health services like doctor visits, preventive care, lab tests, diagnostic screenings, durable medical equipment and home health care. Many preventive services, such as annual wellness visits and cancer screenings, come at no out-of-pocket cost, helping you stay on top of your health without unexpected bills.
However, it’s important to plan for Medicare Part B costs, which include a monthly premium, annual deductible and coinsurance — typically about 20% of the cost for most services after you meet your deductible. Premiums are based on income and may be deducted automatically from Social Security benefits. For those concerned about out-of-pocket expenses, supplemental insurance plans and Medicare Savings Programs can provide additional financial protection, ensuring peace of mind as you navigate your Medicare options.
The key takeaways and summary were created with the assistance of generative AI. An AARPeditor reviewed and refined the content for accuracy and clarity.
Full Transcript:
[00:00:00] If you’re getting close to retirement, you may be trying to figure out how
Medicare fits into the full picture of your medical coverage.
[00:00:07] Medicare Part B will be an important part of that process, because it covers a
wide array of health services.
[00:00:13] Hi, I’m Tricia Sandiego. Part of my job at AARP is to help people understand how to
[00:00:18] get the most out of Medicare. So how does Medicare part B work, and what are the costs?
[00:00:27] Let’s start with some basics about what’s covered. Medicare Part B is the part of Medicare that covers doctor visits and anything
[00:00:34] that doesn’t require a hospital stay. It also covers preventive care, like wellness visits or flu shots,
[00:00:41] lab services like blood tests, diagnostic tests like MRIs or mammograms, medical equipment like wheelchairs, oxygen and transportation,
[00:00:51] and some home health services. Just like insurance under your employer, some of these preventive services and screenings are covered on set schedules.
[00:01:00] Typically, preventive services do not cost you anything out of pocket. However, if your doctor runs a test to diagnose or treat a disease or
[00:01:08] condition, you will incur a cost. Speaking of costs, you’re probably wondering what’s free and what you’ll pay
[00:01:15] for under Medicare Part B. No problem. I’ll start with services that don’t require any out-of-pocket costs.
[00:01:22] For example, wellness visits. That’s all your regular doctor checkups. These include breast exams,
[00:01:28] colorectal and prostate cancer screenings, as well as some other tests and vaccines based on your age and risk factors.
[00:01:35] Now to out-of-pocket costs. Even though Medicare Part B covers many of your expenses, you will have to pay a premium, a deductible, and when applicable,
[00:01:45] coinsurance. Part B has a monthly premium. It’s either deducted from your Social Security benefits check
[00:01:51] or you pay it directly to Medicare. The amount you pay can vary depending on your income. Each year
[00:01:57] you’ll also pay an annual deductible before most Part B coverage begins. The amount of that deductible is set each year.
[00:02:05] You’ll also pay coinsurance. It’s about 20% of the cost of most doctor visits that are not
[00:02:11] part of your wellness visit. Let’s look at an example. Say you go to a specialist to get checked for stomach pains.
[00:02:18] They charge $500 for the visit. Medicare would pay $400, or 80%, and you would pay $100, which is 20%.
[00:02:29] Now say your doctor finds something during a screening that requires additional treatment. Medicare would cover the screening, but you may have to pay extra for
[00:02:38] services such as removing a polyp during a colonoscopy, for example. Be sure to contact Medicare to find out if the services needed are covered.
[00:02:46] And when it comes to out-of-pocket expenses, you may want to consider buying a supplemental insurance plan.
[00:02:53] You can find more about that in this video’s description. If you need financial assistance, you may be eligible for a Medicare
[00:02:59] Savings Program based on your income. I hope this video helps you understand your Medicare Part B coverage and
[00:03:06] gives you the knowledge you need to make an informed decision. For more helpful information, visit aarp.org/medicare.
