Medicare Part B is a crucial component of your healthcare coverage, offering medical services that help you stay healthy and catch potential problems early. Whether you’ve had Medicare Part B for years or you’re just getting started, knowing how to get the most out of your benefits can save you time, money, and stress. Let’s explore how you can make the most of your Medicare Part B benefits.

Understanding Medicare Part B

Medicare Part B covers two main types of services: medically necessary services and preventive services. Medically necessary services include those needed to diagnose and treat a medical condition, such as doctor visits, lab tests, X-rays, and outpatient services. Preventive services include screenings, vaccines, and annual wellness visits that help you avoid illness or detect it early when treatment is more effective.

While Medicare Part A (Hospital Insurance) covers things like inpatient hospital care, skilled nursing facilities, and hospice, Medicare Part B is the coverage you’ll use for most of your routine health care. That’s why it’s so important to understand exactly what Part B covers—and how you can take advantage of it.

Know What’s Covered

To maximize your Medicare Part B benefits, you need to know what’s covered. Some of the services covered under Part B include:

  • Doctor visits
  • Outpatient care (like surgeries and diagnostic tests)
  • Durable medical equipment (such as wheelchairs and walkers)
  • Mental health services (including counseling and psychiatric visits)
  • Some home health services
  • Preventive services, including flu shots, mammograms, colonoscopies, and diabetes screenings

Many preventive services are available at no cost to you if the provider accepts Medicare. Staying on top of your preventive care is a key way to get the most out of your benefits because these services can help detect issues early or prevent illness altogether. Be sure to confirm that your provider accepts Medicare assignment.

Take Advantage of Preventive Care

One of the best ways to maximize your Medicare Part B benefits is by using the preventive services available to you. These services are designed to help you maintain your health and detect any issues before they become more serious.

Here are some examples of the preventive services covered by Medicare Part B:

  • Annual Wellness Visit: Each year, you are entitled to a wellness visit to create or update a personalized prevention plan based on your current health and risk factors.
  • Screenings: Services like mammograms, prostate cancer screenings, and osteoporosis tests can catch diseases early, giving you a better chance at successful treatment.
  • Vaccinations: Medicare Part B covers vaccines like the flu shot, pneumonia vaccine, and the COVID-19 vaccine.

To see the full list of preventive services covered under Medicare Part B, check out the Medicare Preventive Services Quick Reference Chart provided by the Centers for Medicare & Medicaid Services.

By staying on top of your preventive care, you’re not only improving your overall health but also ensuring that your healthcare costs stay low by catching issues early.

Choose the Right Providers

Choosing doctors and healthcare providers who accept Medicare assignment can significantly lower your out-of-pocket costs. Medicare assignment means the provider has agreed to accept the Medicare-approved amount as full payment for their services.

If your doctor doesn’t accept Medicare assignment, you may be charged up to 15% more than the Medicare-approved amount. Make sure to ask your provider if they accept Medicare assignment before scheduling an appointment to avoid any surprise bills.

Understanding Out-of-Pocket Costs

While Medicare Part B covers many services, it doesn’t cover everything. You’re typically responsible for paying a monthly premium, and you’ll likely have a deductible before Medicare starts to pay its share. After you meet your deductible, you usually pay 20% of the Medicare-approved amount for services.

You may also want to consider additional coverage, like a Medigap plan (also known as Medicare Supplements) or Medicare Advantage, to help lower your out-of-pocket costs. These plans can help cover the gaps in Medicare, such as co-pays, deductibles, and additional services that Part B doesn’t cover.

Utilize Telehealth Services

Medicare has expanded coverage for telehealth services, allowing you to see your doctor from the comfort of your own home. Telehealth can be a convenient and cost-effective way to access the care you need, especially for follow-up visits or managing chronic conditions. Many of these services are covered under Medicare Part B, and the pandemic has made telehealth a much more widely accepted form of healthcare.

Keep Track of Your Healthcare Costs

It’s essential to keep track of your healthcare expenses, including doctor visits, tests, and medications. Reviewing your Medicare Summary Notice (MSN), which you receive every three months, helps ensure you’re only being charged for services you actually received. It also lets you check that your providers are billing Medicare correctly.

By staying on top of your paperwork and keeping track of your healthcare costs, you can avoid surprises and catch any billing errors early.

Take Full Advantage of Your Medicare Part B Benefits

Maximizing your Medicare Part B benefits means knowing what’s covered, taking advantage of preventive care, choosing the right providers, and keeping an eye on your out-of-pocket costs. Staying informed and proactive about your health and your benefits ensures that you’re getting the most value from your coverage.

If you want to learn more about how to make the most of your Medicare benefits, consider joining one of GetSetUp’s Medicare classes. Our Guides will walk you through the ins and outs of Medicare, so you feel confident and empowered to manage your healthcare.