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:

https://www.medicare.gov/coverage/is-your-test-item-or-service-covered

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 Medicare.gov 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.

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:
https://www.medicare.gov/coverage/is-your-test-item-or-service-covered

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 Medicare.gov 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.