man explaining medicare health plans for seniorsLet’s Walk Through It

Part B is the second component of Original Medicare offered by the government.  It is voluntary, but most will take it when first eligible.  The current cost for Part B is $104.90.  The government can change that premium each year.  Some seniors pay more for Part B based on their income. It covers various medical needs like doctor visits, outpatient, and medical equipment.  It has deductible and copays, and together A and B is referred to as original Medicare.

This plan will cover services such as doctor appointments, surgeries and lab tests. It will also assist you with any additional supplies you might need such as a walker or wheelchair that have been deemed medically important to your condition or disease.

If you are currently enrolled in Medicare Part C (also known as Medicare Advantage) it is very probable that you have different rules. For the most part, your insurance plan must give you at least some form of coverage from Original Medicare. In some cases, certain conditions or settings might require specific coverage.

Part B will offer the following services:

  • Services that are medically important – supplies and services that are needed to treat or diagnose your health condition and that meet agreed upon standards of practice
  • Preventative measures – designed to prevent illnesses such as the flu and to detect it early on when treatment can be the most successful

Additional coverage from Part B

  • Prescription outpatient drugs (limited)
  • A second opinion from a doctor prior to a surgery
  • Mental health (outpatient, inpatient, partial hospitalization)
  • Clinical research
  • Ambulance service
  • DME (durable medical equipment)

Does Medicare cover what you need?

Speak with your healthcare provider or doctor to make this assessment and determine why you need certain services or supplies. Find out if Medicare would cover them. In some cases you might need something that is normally covered but your provider does not think it will qualify you might have to sign a notice stating that you might have to pay for the supplies, service, or available item.

It is important to know that Medicare coverage relies on 3 main points:

  • Laws – federal and state
  • Coverage decisions on a national level made by Medicare about whether or not something is covered
  • Decisions from local companies in each state that will process your claim for Medicare. In many situations, these companies will decide whether something is necessary medically and whether or not their area will require coverage.

Contact us today for specific information about your coverage.


Your Recommended Agent is Greg from BGA Insurance Group

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Greg Gudis – Licensed agent ready to assist you during the enrollment period in 2016. Please fill out the form below to send your information to Greg so that he can contact you with the best advice and plan information for your current situation. He can also provide expert advice on retirement planning, life insurance, and long-term care.

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This is a solicitation of insurance. By providing this information, you agree that an authorized representative or licensed insurance agent/producer may contact you by phone, e-mail, or mail to answer your questions or provide additional information about Medicare Advantage, Part D or Medicare Supplement Insurance plans.