YOUR MEDICARE BENEFITS
YOUR
MEDICARE
BENEFITS
This official government guide has important information about the items and services Original Medicare covers.
2019
CENTERS FOR MEDICARE & MEDICAID SERVICES
Your Medicare Benefits
The information in "Your Medicare Benefits" describes the Medicare Program at the time it was printed. Changes may occur after printing. Visit or call 1-800-MEDICARE (1-800-633-4227), to get the most current information. TTY users can call 1-877-486-2-48. "Your Medicare Benefits" isn't a legal document. Official Medicare Program legal guidance is contained in the relevant statutes, regulations, and rulings.
CENTERS FOR MEDICARE & MEDICAID SERVICES
ABOUT
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THIS BOOKLET
This booklet describes many, but not all, of the health care items and services covered by Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). It includes information on how and when you can get these benefits and how much you'll pay. "Your Medicare Benefits" lists many, but not all, of the items and services that Original Medicare covers. If you have a question about a test, item, or service that isn't listed in this booklet, visit or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. If you have a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan, you have the same basic benefits as people who have Original Medicare, but the rules vary by plan. Some services and supplies may not be listed because the coverage depends on where you live. For more information, contact your plan.
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SECTION
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Before you read this booklet
Review the questions and answers below before you read "Your Medicare Benefits." They explain information that will be important in understanding Medicare coverage.
What's the Part B deductible?
In 2019, you pay a yearly $185 deductible for Part B-covered services and supplies before Medicare begins to pay its share, depending on the service or supply.
What's assignment, and why is it important?
Assignment is an agreement by your doctor, provider, or supplier to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance.
Depending on the service or supply, actual amounts you pay may be higher if doctors, other health care providers, or suppliers don't accept assignment. Doctors who don't accept assignment may charge you more than the Medicare-approved amount for a service, but they can't charge more than 15% over the Medicare-approved amount for nonparticipating doctors. This is called the "limiting charge." The limiting charge applies only to certain services and doesn't apply to some supplies and durable medical equipment (DME). When getting certain supplies and DME, Medicare will only pay for them from suppliers enrolled in Medicare, no matter who submits the claim (you or your supplier).
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