Medicare Basics

Medicare Part B Explained

Outpatient coverage, the annual deductible, and the 20% you are left holding.

About 9 minute read

Overview

Part B is the outpatient half of Original Medicare. It covers physician services, outpatient hospital care, preventive services, lab work, imaging, and durable medical equipment.

How it works

Part B carries a monthly premium, an annual deductible, and then generally pays 80% of the Medicare-approved amount for covered services. The remaining 20% has no annual cap under Original Medicare alone.

What to watch for

That uncapped 20% is the single most misunderstood feature of Medicare. On a routine office visit it is small. On chemotherapy, dialysis, or a long course of specialty care it is not.

What to do next

Nothing is covered at 100%. Planning for the 20% before you need it is the entire reason Medicare Supplement plans exist.

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The information on this site is educational only and is not medical, legal, or tax advice. Medicare Supplement (Medigap) benefits are standardized where applicable, but premiums, availability, and underwriting rules vary by carrier and by state. Gilbert Services Southwest is not affiliated with or endorsed by the federal government or the Centers for Medicare & Medicaid Services. Please consult a licensed insurance professional about your individual circumstances.

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