medicare part b covers
Medicare Part B generally covers outpatient medical care, doctor services, and many preventive services, but it does not cover everything you might assume “health insurance” would pay for. It usually pays about 80% of approved costs after you meet the annual deductible, leaving you with the remaining share unless you have other coverage.
What Medicare Part B covers
Medicare Part B is designed to cover medically necessary services and many preventive benefits you receive outside of an inpatient hospital stay. It is part of “Original Medicare,” along with Part A, and applies mainly to outpatient settings.
Key categories Part B typically covers include:
- Doctor visits (primary care and specialists) when medically necessary.
- Outpatient hospital services, like same‑day surgery or ER visits before you’re admitted as an inpatient.
- Certain prescription drugs you do not administer yourself (for example, many IV drugs given in a doctor’s office).
- Medically necessary diagnostic tests, such as blood work, imaging (X‑rays, MRIs), and other lab tests.
Preventive services and screenings
Part B includes a wide range of preventive services aimed at finding problems early or helping you stay healthy. In many cases, you pay nothing for these services if your provider accepts Medicare assignment and the service meets Medicare criteria.
Common preventive benefits under Part B include:
- Annual wellness visits and many routine checkups.
- Vaccines such as flu, pneumonia, COVID‑19, and hepatitis B for people at certain risk levels.
- Screenings for conditions like diabetes, depression, heart disease, certain cancers (e.g., colonoscopy, mammograms), HIV, and STIs when eligibility rules are met.
Other major services Part B helps pay
Beyond office visits and screenings, Part B can cover a variety of outpatient treatments and supports. Cost‑sharing (like coinsurance) usually applies, so many people pair Part B with Medigap or other supplemental coverage.
Examples of additional Part B‑covered services:
- Durable medical equipment: wheelchairs, walkers, oxygen equipment, and similar items when medically necessary.
- Some home health care services if you meet Medicare’s criteria.
- Outpatient mental health care, including therapy in clinics or offices.
- Ambulance transportation in emergencies, and sometimes non‑emergency transport when no safe alternative exists.
- Certain therapies such as physical, occupational, and speech therapy when ordered as medically necessary.
What Medicare Part B does not cover
Part B leaves out several types of care that people often expect will be included, which is why many look at Part D, Medigap, or Medicare Advantage to fill gaps. Knowing these exclusions helps you plan for out‑of‑pocket costs.
Common services Part B does not cover include:
- Most routine dental care and dentures.
- Routine eye exams for glasses and most eyeglass costs.
- Hearing aids and exams specifically for fitting hearing aids.
- Long‑term custodial care in a nursing home.
- Routine cosmetic surgery and concierge‑style medical services.
- Most drugs you take yourself at home (those are usually under Part D).
Quick HTML table of major coverage areas
| Category | Examples | Covered by Part B? |
|---|---|---|
| Outpatient medical care | Doctor visits, outpatient ER, same‑day surgery | [1][3]Yes, if medically necessary and Medicare‑approved | [1][3]
| Preventive services | Annual wellness visit, vaccines, cancer screenings | [5][3]Yes; often no cost if criteria met | [5][3]
| Durable medical equipment | Wheelchairs, walkers, oxygen equipment | [7][1]Yes, when ordered as medically necessary | [1][7]
| Home health care | Certain skilled nursing or therapy at home | [3][1]Yes, if Medicare home health rules are met | [3][1]
| Mental health (outpatient) | Therapy visits, some clinic services | [7][3]Yes, with coinsurance after deductible | [3][7]
| Routine dental & vision | Teeth cleanings, fillings, eyeglass exams | [7][3]No, not under Part B in most cases | [3][7]
| Hearing aids | Hearing aids and fitting exams | [7][3]No; typically not covered by Part B | [3][7]
| Long‑term custodial care | Nursing home room and board for assistance with daily activities | [7][3]No; Part B does not cover custodial care | [3][7]
| Self‑administered prescriptions | Most take‑at‑home medications | [5][3]No; usually covered by Part D instead | [5][3]