If you are eligible for Medicare Part B, you should know how much of the program it covers. Not every need is provided for, including preventive services unrelated to end-of-life care. For example, patients can get their eyes checked for either treatment or prevention with a vision exam. This means the examination is not covered if an ophthalmologist finds a condition that needs to be treated right away instead of preventively planning. It is best to consult with a licensed Medicare insurance agent to learn more about Medicare supplement plans when you have questions.
Medically Necessary Services
Medically necessary services are essential medical care, treatment, or supplies to prevent, diagnose, or treat an illness, injury, condition, disease, or symptoms. When you’re covered by a Medicare Part B plan in 2022—like a Medicare Advantage plan with built-in Part B coverage—you’ll typically have access to the medically necessary services you need.
Medically necessary services include:
- Durable medical equipment (DME)
- Clinical tests
- Mental health services
- Outpatient care
- Physical and occupational therapy
- Second surgical opinions
Medicare Part B plans are the health insurance plans that cover doctor visits, hospital stays, and other medical services. Medicare Part B is often called “medical insurance” because it’s a separate program from Medicare Part A, covering hospitalization and related care.
The government runs these plans through private insurance companies. You can choose between a variety of different options, including:
Medicare Advantage Plans: These are similar to HMOs or PPOs, but private companies offer them instead of government-run them. They provide Part A and Part B coverage at a lower cost than traditional Medicare.
Private Fee-for-Service Plans: This kind of plan will pay for any service from any provider regardless of whether they accept Medicare or not. You’ll need to get authorization from your plan before going to an out-of-network doctor or hospital, though — otherwise, you won’t be able to get reimbursed for the visit!
Medicare pays for preventive services that can help you stay healthy, avoid illness and disease, and manage chronic conditions. These include but are not limited to:
- Screenings and tests
- Diabetes self-management training
- Follow-up visits with specialists
How to Find Out If Medicare Part B Covers What You Need
You can use MedicareConsumer.com to determine better what Medicare Part B covers. Just enter “Medicare Part B” in the search box at the top of any Medicare page and follow the instructions on that page. You will see what is covered by Medicare Part B and what is not covered by Medicare Part B. The site also has a telephone number for a live person to help you with your questions about Medicare Part B coverage and Medicare Part B Costs.
If you have specific questions about what is covered under your Medicare plan, you should call your plan’s customer service line or visit its website. The customer service representative will be able to tell you whether or not your plan covers what you need to know. This can be helpful if you’re considering switching insurance plans or if your current plan doesn’t cover something that you need to know about to make an informed decision about your future health care needs.
The Bottom Line on Medicare Part B Plans for 2022
Although Medicare Part B looks a lot like traditional health insurance, it’s different in critical ways, such as Medicare Part B requirements. It isn’t designed to cover most medical services you might use during a given year. Instead, it serves as an insurer of last resort for those particular services (as well as for other costs) that your other insurance does not cover – and only for those who have no additional coverage.