Medicare Part B covers medical expenses like doctor’s visits, diagnostic tests, outpatient care, and preventive care.
Medicare Part B generally covers outpatient care, or care you receive in a doctor’s office or other clinic, rather than while admitted to a hospital. Part B includes medically necessary services to treat a medical disease or condition. It also covers preventive care such as:
- screenings
- certain vaccines
- mental health counseling
- a yearly wellness visit
Parts A and B together are often referred to together as Original Medicare.
Keep reading to learn more specifics about what Plan B covers.
Medicare Part B covers 80% of the Medicare-approved costs of certain services. Most, though not all, of these services are administered outpatient. This means you don’t receive them as a patient in a hospital.
Part B also covers emergency room visits and the services you receive there, even if you’re later admitted to a hospital. However, once you’re admitted, Part A will cover those costs.
To get coverage, a Medicare-approved supplier must administer your care, such as an MD, DO, NP, or another medical professional who has not opted out of providing Medicare-covered services.
Services that Medicare Part B covers include:
Doctor’s visits, vaccines, and screenings
- doctors’ visits, both medically necessary and preventive, provided that they’re from a Medicare-approved supplier
- medically necessary outpatient hospital care, such as emergency room services and some same-day surgical procedures
- certain prescription medications, such as those administered intravenously or by a physician
- vaccines for the flu, pneumonia, COVID-19, and hepatitis B (if you’re at medium or high risk for hepatitis B)
- screenings and tests for conditions including:
- hepatitis C
- glaucoma
- diabetes
- depression
- heart disease
- alcohol misuse
- sexually transmitted infections (STIs)
- lung cancer and other cancers
- hepatitis C
- HIV
- alcohol misuse disorder
- colorectal cancer, including colonoscopy, sigmoidoscopy, stool tests, barium edemas, and blood-based biomarker tests
- preventive mammograms, if you meet the criteria, and diagnostic mammograms, if needed
- Pap smears
- laboratory tests, such as blood tests
- X-rays
Medically necessary services
- durable medical equipment, such as oxygen tanks
- some home health services
- emergency transportation services, such as an ambulance
- some nonemergency transportation services, provided that there’s no safe alternative
- mental health services
- chiropractic care for spinal subluxation
Counseling and behavior modification programs
- behavioral modification programs for obesity
- smoking cessation counseling
- alcohol misuse counseling
- medical nutrition therapy services if you have diabetes, kidney disease, or had a kidney transplant in the last 3 years
- Medicare Diabetes Prevention Program
Medicare Part B does not cover costs that Medicare Part A covers or services you have coverage for through Medicaid or a Medicare Advantage Plan.
Medicare Part B does not cover covered services provided by a doctor who has opted out of providing Medicare services, except in emergencies.
Medicare Part B also does not cover:
- most dental care
- dentures
- yearly eye exams for prescription lenses
- hearing aids and hearing exams for fitting hearing aids
- long-term care in a nursing home (custodial care)
- concierge care
- cosmetic surgery
- massage therapy
- prescription drugs you give to yourself, as this is covered by Part D
- some vaccines, such as the shingles vaccine, which is covered by Part D
If you aren’t sure Medicare Part B covers a service, you can search for a specific service on Medicare.gov.
Your choice of plan will depend on your individual needs.
You can choose an Advantage plan (Medicare Part C) instead of Medicare Parts A, B, and D.
Medicare Advantage plans vary both from Medicare Part B and from each other. They may have different costs, rules, and restrictions, which can vary yearly.
For example, some Medicare Advantage plans restrict the doctors you can see to an in-network group. Medicare Part B may have a larger pool of doctors for you to choose from.
Medicare Advantage plans are required to cover at least as much as Medicare Parts A and B. Some cover additional services, such as:
You’re not obligated to remain with your Medicare plan choice if it doesn’t suit you, your needs change, or for any reason.
During open enrollment periods annually (October 15 to December 7), you can choose a different Medicare plan. This allows you to change from Original Medicare (Parts A and B) to a Medicare Advantage plan or vice versa.
During open enrollment periods, you can also add services such as Medicare Part D (prescription drug coverage) and Medicare supplemental insurance plans (Medigap).
Important Medicare deadlines
- Initial enrollment: You can get Medicare as you approach your 65th birthday during a 7-month period that starts 3 months before you turn 65 and ends 3 months afterward. If you’re currently working, you can get Medicare within an 8-month period after retirement or after opting out of your employer’s group health insurance plan and still avoid penalties. You can also enroll for a Medigap plan any time during the 6-month period that begins with your 65th birthday.
- General enrollment: For those who miss initial enrollment, there’s still time to sign up for Medicare from January 1 through March 31 each year. However, you may be charged an ongoing late enrollment penalty if you choose this option. During this period, you can also change or drop your existing Medicare plan or add a Medigap plan.
- Open enrollment: You can change your current plan any time from October 15 through December 7 annually.
- Enrollment for Medicare add-ons: From April 1 through June 30 you may add Medicare Part D prescription drug coverage to your current Medicare coverage.
Medicare Part B covers outpatient care, such as doctor visits and screenings.
Part B includes medically necessary care and preventive care.
You will pay an annual deductible and monthly premium for Medicare Part B.
Medicare plan options and costs are subject to change each year.