Medicare Part B is medical insurance. It’s one part of what’s often called Original Medicare, which is administered by the federal government. Medicare Part A (hospital insurance) is the other part.

Medicare Part B helps pay for care you receive in a clinic or hospital as an outpatient. Part B also covers most doctor services you receive as a hospital inpatient. Most other hospital services are covered by Part A.

What Does Medicare Part B Cover?

Medicare Part B covers doctor visits and most routine and emergency medical services. It also covers some preventive care, like flu shots. The list below shows more examples of what Part B covers.

What does Medicare part B cover

Original Medicare doesn't cover prescription drugs.

Medicare Part B covers some medications that your doctor administers during an office visit, but it doesn't cover prescription drugs. Part A doesn't either.

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What Does Medicare Part B Cost? 

Medicare Part B shares some costs with you when you see the doctor or use other medical services. The table below shows the different costs that may apply. Costs shown are for 2016. 

Part B charges a monthly premium. The payment is deducted from your monthly check if you receive Social Security benefits. Otherwise you need to send a monthly premium payment to Medicare.

Premium
Per month  $104.90 to $389.80 depending on income
Deductible
Per year  $166 
Co-insurance
Most medical services  20% of the Medicare-approved amount
Durable medical equipment  20% of the cost Medicare-approved amount 
Outpatient mental health care  35% of the Medicare-approved amount 

Working past 65?

You may be able to delay enrolling in Part B–and postpone paying the premium–without penalty.

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How Medicare Part B Cost Sharing Works

Medicare Part B pays 80% of the cost for most outpatient care and services, and you pay 20%. But there is something called “Medicare assignment” that’s important to understand.

Doctors and providers who accept Medicare assignment agree to take what Medicare pays—the Medicare-approved amount—as payment in full. Medicare reduces the approved amount it pays for doctors who don’t accept Medicare assignment.

Doctors who don’t accept Medicare assignment may charge more than the Medicare-approved amount. You may have to pay the additional cost, which is called “excess charges.”

Ellen's story may help you understand how Part B cost sharing might work when doctors accept Medicare assignment and when they don't.

Meet Ellen

Meet Ellen

Ellen visits her doctor for chest pain. The doctor orders tests to help determine what the problem might be.

Learn more about Ellen...

Guide to Original Medicare (Part A & Part B)

Find out more about Original Medicare. What’s the difference between Part A and Part B? What’s covered and what’s not? Do you have to pay a premium?