Medicare Part B is medical insurance. It covers things like doctor visits, blood tests, medical equipment, flu shots and more.
You do not get this coverage unless you sign up for it.
Most Part B enrollees pay a monthly premium ($148.50), an annual deductible ($203) and 20% of the Medicare approved amount after you meet the deductible.
Unfortunately, there is no maximum out of pocket limit for Part B medical care. You will pay 20% of all your medical expenses, whether those bills add up to $500 or $500,000.
Medicare supplement plans will pay for most or all of those expenses.
People with a Medigap Plan F, for example, do not pay the Part B deductible and they do not pay its 20% coinsurance. Their supplement pays the part of the bill that Medicare does not pay.
The Original Medicare plan has no doctor network. As long as your care is medically necessary and the doctor accepts Medicare assignment, your care will be covered by Medicare.
Medically necessary care has a broad definition. When you need care to diagnose or treat a health condition, and when that care meets the acceptable standards of medicine, it is considered medically necessary.
Imagine that your doctor finds a lump on your breast. He orders an expensive kind of MRI just approved by the FDA. In his medical judgment, this scan will be the best way to rule out cancer.
Although other doctors may have handled your case differently, the things your doctor ordered are still reasonably necessary for you to be well.
Keep in mind that while Medicare Part A is hospital insurance, it does not cover all the care you receive in the hospital. It is common for a patient to receive medical care in a hospital setting; for example, a visit from their primary care doctor.
This care would be covered by Medicare Part B, which means you may be subject to a deductible and 20% coinsurance when your primary care doctor sends his bill to Medicare.