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Starting the Dialogue with Your Aging Parents About Medicare Part B

October 7, 2013

I’d like to continue our discussion of Medicare and the various parts and plans. Remember, this is just a brief overview and meant to give you a taste of what is available. For specific answers to questions you can call 1-800-633-4227, visit the website, or read through the Medicare handbook entitled Medicare and You which is updated annually.

 Today I’d like to focus on Medicare Part B.  Many people refer to this as their Medicare Medical Insurance as opposed to Medicare Part A which is considered as Medicare Hospital Insurance. Both parts encompass more than just hospital or medical and we’ll discuss that further in a few minutes.

Medicare Part B is optional. Payroll deductions taken toward Medicare while your parents were working only applied to Medicare Part A. That eans premiums apply to Medicare Part B as well as deductibles, co-payments, and co-insurance.  For those with original Medicare this means that if a provider is seen who accepts assignment from Medicare the patient must meet their annual deductible (except for preventive services exempt from the deductible) and then will be responsible for 20% of the Medicare approved charges unless there is co-insurance to pick up that 20%.

The percentage of patient responsibility or co-insurance may be different if your parents have Medicare Advantage or if Medicare Part B is administered through an insurance plan or HMO, PPO, or MCO.  In addition, Medicare may not cover certain items if there is other insurance that will pay or if there is Medicaid coverage. It is very important to know and understand what services are covered and what charges the patient or coinsurance will be responsible for prior to scheduling appointments, receiving services such as lab tests and radiology procedures, or seeking durable medical equipment and supplies.

Medicare Part B will cover the following if the services are deemed to be medically necessary:

Medical Appointments                  Outpatient Care                 Chemotherapy                 Cardiac Rehabilitation

Tele-health                                       Laboratory Tests               Defibrillator (implant)      Diabetes Supplies


Yearly Wellness Exams                  Chiropractic                        Preventive Services         Ambulance Services

Durable Medical Equipment        Preventive Services           Bone Mass Measurement

This is not an exhaustive list and many of the services listed above also have certain conditions which must be met.  For a better understanding of Medicare Part B I refer you back to the resources mentioned at the beginning of this post.  In addition, Geriatric Care Managers are a great resource and can offer assistance in understanding the ins and outs of the various Medicare plans.

If you have further questions or comments I would love to hear from you in the comments.  In addition, if anyone has a story to share regarding use of Medicare Part B please share it with us in the comments as well.

Thank you for being a part of this blog community. Your input is always appreciated and all comments are welcome!

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