Medicare Part B

Medicare Part B covers two types of services:
  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage when treatment is most likely to work best.
Part B covers things like:
  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health
  • Limited outpatient prescription drugs
Medicare Part B (Medical Insurance) covers:
  • Abdominal aortic aneurysm screening
  • Alcohol misuse screenings & counseling
  • Bone mass measurements (bone density)
  • Cardiovascular disease screenings
  • Cardiovascular disease (behavioral therapy)
  • Cervical & vaginal cancer screening
  • Colorectal cancer screenings
  • Multi-target stool DNA tests
  • Screening barium enemas
  • Screening colonoscopies
  • Screening fecal occult blood tests
  • Screening flexible sigmoidoscopies
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training
  • Glaucoma tests
  • Hepatitis B Virus (HBV) infection screening
  • Hepatitis C screening test
  • HIV screening
  • Lung cancer screening
  • Mammograms (screening)
  • Nutrition therapy services
  • Obesity screenings & counseling
  • One-time “Welcome to Medicare” preventive visit
  • Prostate cancer screenings
  • Sexually transmitted infections screening & counseling
  • Shots:
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation counseling
  • Yearly "Wellness" visit
What is not covered by Medicare Part A & Part B?

Medicare does not cover everything. Some of the items and services Medicare does not cover include:

  • Long-term care (also called custodial care)
  • Most dental care
  • Eye exams related to prescribing glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care
Find out if Medicare covers a test, item, or service you need here:

What do I pay for Part B-covered services?

You will pay more if you see doctors or providers who do not accept assignment. If you are in a Medicare Advantage Plan or have other insurance (like a Medigap policy, Medicaid, or employer or union coverage), your copayments, coinsurance, or deductibles may be different.

Under Original Medicare, if the Part B deductible ($198 in 2020) applies, you must pay all costs (up to the Medicare-approved amount) until you meet the yearly Part B deductible. Visit in the Fall of each year to find out how much the Part B deductible will be.

After your deductible is met, Medicare begins to pay its share and you typically pay 20% of the Medicare-approved amount of the service if the doctor or other health care provider accepts assignment. There is no yearly limit for what you pay out-of-pocket.

You pay nothing for most covered preventive services if you get the services from a doctor or other qualified health care provider who accepts assignment. However, for some preventive services, you may have to pay a deductible, coinsurance, or both. These costs may also apply if you get a preventive service in the same visit as a non-preventive service.