Medicare Part B covers doctor visits, outpatient hospital care, medical equipment, and preventive services

Medicare Part B is the medical insurance piece of Original Medicare. It pays for services from doctors and other providers when you go to their office, a clinic, or an outpatient hospital department — not when you stay overnight in a hospital bed. Part B also covers certain equipment, tests, and preventive visits at no cost to you.

You pay a monthly premium for Part B (the amount changes each year based on your income), and then you pay a share of the cost when you use a service. Understanding what Part B covers helps you know what to expect at the doctor's office and what bills might come your way.

Key Takeaways

  • Part B covers doctor office visits, urgent care, and outpatient hospital services like lab work and imaging.
  • You pay a monthly premium plus a share of each service cost (usually 20 percent after you meet your deductible).
  • Preventive services like annual wellness visits, cancer screenings, and vaccines are covered at no cost to you.
  • Part B does not cover dental, vision, hearing aids, or long-term care — you may need separate coverage for those.
  • If you see a provider who does not accept Medicare, you may owe the full bill yourself.

Doctor and Specialist Visits Covered by Part B

Part B pays for visits to your primary care doctor, specialists, and other providers who accept Medicare. This includes office visits for new problems, follow-up appointments, and routine check-ups. If your doctor orders tests, imaging, or procedures during that visit — such as blood work, an X-ray, or an EKG — Part B covers those too, as long as they happen in an outpatient setting.

You will owe a copay or coinsurance at each visit. A copay is a flat fee (for example, $15 per visit). Coinsurance means you pay a percentage of the cost — typically 20 percent — after you have paid your yearly deductible. Your deductible is the amount you must pay out of your own pocket before Part B starts to pay its share. The Part B deductible amount changes each year.

Part B also covers telehealth visits with doctors who accept Medicare, so you can see a provider by video or phone from home. The cost works the same way as an in-person visit.

Outpatient Hospital Services and Urgent Care

When you need care that does not require an overnight hospital stay, Part B covers the service if it happens in an outpatient hospital department. This includes emergency room visits, same-day surgery, imaging centers, and lab work done at a hospital facility. You pay the same coinsurance (usually 20 percent after your deductible) whether you go to a doctor's office or a hospital outpatient department.

Urgent care clinics are also covered by Part B if the clinic is set up as a Medicare provider. However, not all urgent care centers accept Medicare, so call ahead to confirm before you go. If you go to an urgent care that does not accept Medicare, you will owe the full bill yourself.

Medical Equipment and Supplies Covered by Part B

Part B covers durable medical equipment — items that last a long time and help you manage a health condition. Examples include wheelchairs, walkers, oxygen equipment, continuous positive airway pressure (CPAP) machines, and diabetic testing supplies. You typically pay 20 percent of the cost after your deductible, and the equipment must be ordered by a doctor.

Part B also covers some supplies that are not durable — items you use up over time. Diabetic test strips, lancets, and glucose monitors are covered. Ostomy supplies, catheter supplies, and wound care supplies may be covered depending on your condition and what your doctor orders.

To get equipment or supplies covered, your doctor must write an order, and you must use a supplier that accepts Medicare. If you buy equipment on your own without a doctor's order, Part B will not pay for it.

Preventive Services at No Cost

Part B covers several preventive services — visits and screenings meant to catch health problems early — at no cost to you. You pay nothing for the service itself, though you still pay your monthly Part B premium. These include an annual wellness visit with your doctor, blood pressure checks, cholesterol screenings, diabetes screenings, colorectal cancer screenings, mammograms, and Pap tests.

Vaccines are also covered at no cost. This includes the flu shot, pneumonia vaccine, shingles vaccine, and COVID-19 vaccine. You can get these at your doctor's office, a pharmacy, or a clinic that accepts Medicare.

The key word is "preventive" — these services are meant to stop disease before it starts or catch it early. If your doctor finds a problem during a preventive visit and needs to do additional testing or treatment, that additional work may not be free and you may owe coinsurance.

What Part B Does Not Cover

Part B does not cover dental care, including cleanings, fillings, and extractions. It does not cover routine vision care, eyeglasses, or contact lenses. Hearing aids and hearing exams are not covered. Long-term care in a nursing home or assisted living facility is not covered by Part B (though Part A covers some skilled nursing care after a hospital stay).

Part B also does not cover cosmetic surgery, weight loss surgery (unless medically necessary), or most prescription drugs. Prescription drugs are covered under Medicare Part D, which is a separate insurance you can add. Physical therapy, occupational therapy, and speech therapy have limits — Part B covers these services, but only up to a certain amount per year, and your doctor must order them.

If you need services that Part B does not cover, you may want to look into a Medigap policy (supplemental insurance) or a Medicare Advantage plan, which may offer additional coverage.

How Much You Pay for Part B Services

Your Part B costs have three parts: the monthly premium, the yearly deductible, and the coinsurance or copay at each visit. The monthly premium is taken from your Social Security check (or you pay it directly if you do not receive Social Security). The amount depends on your income — higher earners pay more.

Once you have paid your yearly deductible, you typically pay 20 percent of the Medicare-approved amount for each service. If a doctor does not accept Medicare assignment (meaning they do not agree to charge the Medicare-approved amount), you may owe more. Always ask whether a provider accepts Medicare assignment before your visit.

Some people may have access to for programs that help pay Part B costs, such as Medicaid or a state information program. If your income is low, you may want to ask your doctor's office or local senior center whether you may have access to for cost help.

Frequently Asked Questions

Do I have to pay anything for preventive services like cancer screenings?

No. Preventive services covered by Part B — such as mammograms, colonoscopies, blood pressure checks, and vaccines — are covered at no cost to you. You pay nothing for the preventive service itself, though you still pay your monthly Part B premium. If your doctor finds something during the screening and does additional testing or treatment, that follow-up care may not be free.

What happens if I see a doctor who does not accept Medicare?

If a doctor does not accept Medicare at all, you will owe the full bill yourself — Medicare will not pay anything. Before your visit, ask the doctor's office whether they accept Medicare. You can also search for Medicare providers in your area on the Medicare website or call 1-800-MEDICARE.

Does Part B cover physical therapy?

Yes, Part B covers physical therapy, occupational therapy, and speech therapy ordered by a doctor. However, there are yearly limits on how much therapy you can receive. Once you reach the limit, you pay the full cost yourself unless you have additional insurance. Your doctor or therapist can tell you how many visits you have left.

Will Part B pay for my hearing aid?

No. Part B does not cover hearing aids or hearing exams. However, some Medicare Advantage plans include hearing coverage, and some states offer programs that help pay for hearing aids. You can ask your local Area Agency on Aging whether your state has a hearing aid information program.

Can I use Part B at any hospital?

Part B covers outpatient services at any hospital or clinic that accepts Medicare. However, if you need an overnight hospital stay, that is covered by Part A, not Part B. Always confirm that a facility accepts Medicare before you go, especially for urgent or emergency care.