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Table 13.4.

Medicare Part B*

What Medicare covers

What you pay**

Physician and other medical services (almost any doctor or hospital in the United States

20% coinsurance other charges (up to 15% above Medicare’s approved charges)

Outpatient hospital care Ambulatory surgical services Home health care

Clinical diagnostic laboratory services

20% coinsurance*** 20% coinsurance*** nothing nothing

Other laboratory tests and X-rays

Diabetes self-management (This

20% coinsurance 20% coinsurance

includes supplies, such as glucose monitors and test strips, and training, all of which are fully

covered. No use of insulin is needed.)

Durable medical equipment Physical therapy Ambulance services Outpatient mental health services Annual flu and pneumonia shots

20% coinsurance*** 20% coinsurance*** 20% coinsurance*** 50% coinsurance nothing****

Mammograms annually (women over age 40 only)

20% coinsurance*** (no Part B deductible)

Pap smears every three years (annually for women at high risk)

nothing

Bone mass measurement

20% coinsurance***

Colorectal cancer screening (annually for men and women ove

r

nothing for blood test 20% coinsurance for

age 50 and those under age 50 but at risk)

colonoscopy and other tests

Prostate cancer screening (annually

20% coinsurance for digital exam

for men age 50 and older)

nothing for PSA test

*Copayment and deductible amounts are as of 2001. **A premium of $50 per month applies to Part B, as does a $100 annual deductible. ***Other charges may apply and will vary depending on the type of service rendered. ****The doctor administering the flu and/or pneumonia shots must accept Medicare assignment for shots to be covered.

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