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Medicare Part B Coverage

What is Medicare Part B?

Medicare Part B is medical insurance. It helps pay for doctor visits and medical care you receive as an outpatient. You are an outpatient when you receive care in a hospital or clinic and are not admitted for an inpatient stay.

Part B also covers most doctor services you receive as a hospital inpatient. Other hospital services are covered under Part A.

What's covered under Medicare Part B?

Doctor's visit (including an annual physical exam)

Ambulatory surgery center services

Outpatient medical services

Some preventive care Care that is meant to keep you healthy or to find illness early when treatment is most effective. Examples of preventive care are flu shots, screening mammograms and diabetes screenings. , like flu and pneumonia shots

Clinical laboratory services (blood tests, urinalysis, etc.)

X-rays, MRIs, CT scans, EKGs, and some other diagnostic tests

Some diagnostic screenings, like colorectal and prostate cancer screenings, and mammograms

Durable medical equipment for use at home (oxygen, wheelchairs, walkers, etc.)

Emergency room services

Skilled nursing care Nursing care that should be provided only by a licensed nurse. and health aid services on a part-time or intermittent basis

Medical health care as an outpatient

A few prescription drugs and vaccines administered by a doctor, like chemotherapy drugs or drugs you take if you’re on dialysis

What's not covered under Medicare Part B?

Medicare Part B does not help with the cost of:

  • Dental, vision or hearing care except in very limited situations.
  • Care received outside the United States except in very limited situations.
  • Custodial care Care that provides help with the activities of daily living, like eating, bathing or getting dressed. Most long-term care is considered custodial care.    such as help with eating, bathing or dressing.

What doctors or health professionals can you see?

You can see any qualified provider in the United States who accepts Medicare and who is accepting new patients. You can receive care in any state or region. Original Medicare Part B offers the same benefits throughout the United States.

What are the coverage limits with Medicare Part B?

Medicare Part B helps pay for any medically necessary care to treat an illness or condition and for some preventive care to help you stay healthy. However it limits coverage for a few services. For example, Part B covers only one flu shot each year.

What is preventive care?

Preventive care includes screenings and tests that help find health problems early so they can be treated. Some services, like flu shots and health education, can help prevent health problems.

  • Abdominal aortic aneurysm screening
  • Alcohol misuse screening and counseling
  • Bone mass measurement (bone density) 
  • Breast cancer screening (mammogram) 
  • Cardiovascular disease (behavioral therapy) 
  • Cardiovascular screening 
  • Cervical and vaginal cancer screening 
  • Colorectal cancer screening 
  • Depression screening 
  • Diabetes screening 
  • Diabetes self-management training 
  • Flu shot 
  • Glaucoma test 
  • Hepatitis B shot 
  • HIV screening 
  • Medical nutrition therapy services 
  • Obesity screening and counseling 
  • Pneumococcal shot 
  • Prostate cancer screening 
  • Sexually transmitted infections screening and counseling 
  • Tobacco use cessation counseling 
  • “Welcome to Medicare” preventive visit 
  • Yearly “Wellness” visit