Medicare
Medicare Part B Coverage
Part B pays for doctors, outpatient care and testing — and leaves 20% of the bill with you.
Medicare Part B is your medical insurance: office visits, specialists, outpatient surgery, lab work, imaging, durable medical equipment and preventive screenings. Nearly every service you use outside a hospital admission runs through Part B.
After the annual deductible, Part B generally pays 80% of the approved amount and you pay the remaining 20% — with no cap. On a routine visit that is pocket change. On chemotherapy, dialysis or a series of infusions, an uncapped 20% is the single largest financial risk in Medicare, and it is the reason almost everyone adds a Supplement or an Advantage plan.
Problems we hear every week
The 20% has no ceiling
Original Medicare alone has no annual maximum out-of-pocket. A serious diagnosis can mean tens of thousands of dollars.
Late enrollment penalties last forever
Sign up late without creditable employer coverage and your Part B premium rises 10% for each 12-month period you delayed — for life.
Higher earners get an unexpected bill
IRMAA surcharges are based on your tax return from two years ago, and a one-time event like selling land can trigger them.
How we solve it
Time your enrollment correctly
We map your Initial Enrollment Period or Special Enrollment Period around your actual retirement date.
Cap your exposure
A Supplement pays the 20% for you; an Advantage plan replaces it with fixed copays and a hard out-of-pocket maximum. We show both side by side.
Appeal an unfair IRMAA
If income dropped because of retirement, a work stoppage or the death of a spouse, we help you file the life-changing-event form.
Ready to see your options?
A review takes about twenty minutes, costs nothing, and ends with real numbers instead of a sales pitch.
What you gain
- No lifetime late-enrollment penalty from a missed deadline
- A predictable ceiling on medical costs instead of an open-ended 20%
- Preventive screenings used to their fullest at no extra cost
- Confirmation that your specialists accept Medicare assignment
Serving Nashville and Middle Tennessee
Middle Tennessee residents often travel to Nashville for specialty care while keeping a primary care physician in Middle Tennessee or Mt. Juliet. We check that both ends of that pattern — plus providers in Carthage, Watertown, Portland and Murfreesboro — line up with whatever coverage you add on top of Part B.
FAQ
Part B questions we answer often
Can I refuse Part B?+
You can, but only creditable coverage from active employment protects you from the late penalty. Retiree coverage, COBRA and marketplace plans generally do not.
How is the Part B premium paid?+
It is usually deducted from your Social Security check. If you are not yet drawing Social Security, Medicare bills you quarterly.
Does Part B cover prescriptions?+
Only drugs administered in a clinical setting, such as infusions. Retail prescriptions require Part D coverage.
What if my doctor doesn't accept Medicare?+
Non-participating providers can charge excess amounts. We flag this during your review and, when it matters, recommend a plan that covers Part B excess charges.
Get a free Part B review
We will compare your options, explain the trade-offs in plain language, and handle the paperwork. Serving Nashville, Middle Tennessee and our entire state.