I’ve been paying into Medicare for years, and I’m not sure why my specialist visits still cost me so much. What am I missing here?
Answered by 2 licensed agents
That’s a great question, and one we hear a lot. Even though you’ve paid into Medicare through payroll taxes, that mainly covers Part A, which is hospital insurance—not everything. Part B, which covers outpatient care like specialist visits, has its own monthly premium and usually only covers 80% of the cost after you meet the deductible. That means you’re responsible for the remaining 20%, and there’s no out-of-pocket max unless you have additional coverage. This is where a Medicare Advantage or Supplement plan can help reduce or cap those costs. It’s frustrating, but you're not alone—Medicare can feel like a maze, and that's why it's worth reviewing your options to see what might lower your expenses moving forward.
Answered by Bill Green on March 26, 2025
Broker Licensed in FL, AL, AZ & 19 other states
You can get the lowest cost if your doctor accepts the Medicare-approved amount as full payment for a covered service. This is called “accepting assignment.
Answered by Peter Yeh on March 21, 2025
Agent Licensed in CA & TX
Tags: Coverage The Medicare System
Agents: Share Your Expertise
Have insights or experiences related to this topic? Help others by sharing your knowledge and answering this question.
Add Your Answer