Medicare Blog Series – Part 2
What Does Medicare Part B Cover?
Shanti
7/7/20262 min read
Medicare Blog Series – Part 2
What Does Medicare Part B Cover?
Understanding Outpatient Medical Services and Advanced Primary Care Management (APCM)
In our previous blog, we introduced Medicare Part A and the services it covers. In this article, we’ll take a closer look at Medicare Part B and the wide range of outpatient healthcare services it provides.
In general, Medicare Part B helps pay for physician visits, outpatient medical care, preventive services, and many medically necessary healthcare services.
Medicare Part B generally covers:
* Physician visits and services provided by other qualified healthcare professionals
* Outpatient hospital services
* Emergency department services
* Diagnostic tests, including:
* Blood tests
* X-rays
* MRI scans
* CT scans
* Durable Medical Equipment (DME), such as:
* Walkers
* Wheelchairs
* Oxygen equipment
* Certain medical equipment used at home
* Home health care
If you do not qualify for home health services under Medicare Part A, you may still be eligible for home health coverage under Medicare Part B, provided Medicare’s coverage requirements are met.
* Physical therapy
* Occupational therapy
* Speech-language therapy
* Outpatient surgical services
* Outpatient chemotherapy
In addition to the services listed above, Medicare Part B may also cover:
* Ambulance services when Medicare coverage requirements are met
* Certain chiropractic services
* Acupuncture for qualifying medical conditions
* Annual influenza (flu) vaccinations
* Mammograms
* Bone density testing
* Many preventive services at no cost to the beneficiary when Medicare coverage requirements are met
* Diabetes supplies
* Kidney dialysis
* Outpatient mental health and substance use disorder treatment
* Electronic visits (E-Visits)
Advanced Primary Care Management (APCM)
One of the newer services available under Original Medicare is Advanced Primary Care Management (APCM).
If your primary care provider participates in this program, you may have access to services such as:
* 24/7 access to your care team through phone calls, patient portals, email, or virtual visits
* Chronic care management
* A personalized care plan based on your health conditions and treatment needs
* Coordination among your healthcare providers
* Follow-up and transitional care after a hospital discharge
* Medication management
These services are similar to the care coordination benefits commonly included in many Medicare Advantage plans.
If you have questions about your Medicare coverage or need help choosing the plan that best fits your healthcare needs, the team at Lionyx Insurance is here to provide free guidance and personalized assistance.
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