Real Dollar Exposure from 20% Part B coinsurance

[RobertB258973]

Looking for a way to estimate the total annual dollar exposure I will have arising from Medicare's 20% Part B Coinsurance.

[GailL1]

@RobertB258973 

That’s gonna depend on your health cost, meaning, your part (20%) of the amount Medicare pays for any covered health care item under Part B for which you medically need.

Traditional Medicare pays usually on a Fee For Service basis - but some services are also bundled so you probably would have to look up each one to determine how it is paid.  It would be an estimate.  And these do change from time to time/ year to year depending on the reimbursement rates established by CMS.

Medicare.gov Procedure Price Lookup for Outpatient Services.

This may not be the full picture - I don’t how much they actually price in this list.

I don’t think there is a place to check for the normal day to day stuff like doc visits, DME cost, etc.

Remember too that this all is based on you using Medicare providers that accept assignment for full payment.  Some docs / facilities don’t - they are either non-participating providers or they might have “opted out” all together.