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Medicare Deductible

12/1/2010 8:56:59 AM

Effective January 1, 2011, the Medicare deductible will be $162.00 for Part B covered services. Beneficiaries will pay $0 for Medicare approved services on laboratory services.

If you are in a Medicare Advantage Plan (like an HMO or PPO0 or have other insurance, your costs may be different.  Contact your plan or benefits administrator to find out about the costs.

 

NEW – Starting January 1, 2011, you will pay nothing for most preventive services if you obtain the services from a doctor or other health care provider who accepts assignment.  For some services you may have to pay coinsurance for the office visit when you obtain these services:

Preventive Services – There is a limitation on these screenings.

Abnormal Aortic Aneurysm Screening – You pay nothing for test.

Bone Mass Measurement – You pay nothing for test.

Cardiovascular Screening - You pay nothing for test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

Colorectal Cancer Screenings –

       Fecal Occult Blood Test - You pay nothing for test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

       Flexible Sigmoidoscopy - You pay nothing for test.

       Colonoscopy - You pay nothing for test.

       Barium Enema - you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

Diabetic Screening - You pay nothing for test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

Flu Shots - You pay nothing for test.

Glaucoma Tests - You generally have to pay 20% of the Medicare-approved amount and the Part B deductible that applies for the doctor’s visit.

Hepatitis B Shots - You pay nothing for the shot.

HIV Screening - You pay nothing for test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

Mammogram - You pay nothing for test.

Physical Exams – Medicare covers two types of physical exams – one when you are new to Medicare and one each year after that.

       The Welcome to Medicare Physical Exam – This has to be done within the first 12 months you have Part B.  You pay nothing for the exam.

       Yearly “Wellness” Exam – if you have Part B for longer than 12 months, starting January 1, 2011, you can get a yearly wellness visit to develop or update a personal prevention plan based on your current health and risk factors.  You pay nothing for the exam and it is covered once every 12 months.

Pneumococcal Shot - You pay nothing for the shot.

Prostate Cancer Screenings - You pay nothing for test, but you generally have to pay 20% of the Medicare-approved amount and the part B deductible that applies for the doctor’s visit.

Smoking Cessation - You generally have to pay 20% of the Medicare-approved amount and the Part B deductible that applies for the doctor’s visit.  If you haven’t been diagnosed with an illness caused or complicated by tobacco, you pay nothing for the counseling sessions.

 

Wanda Weaver

TCMA