Medicare Part B covers doctor visits, outpatient hospital care, diagnostic tests, and some preventive services

Medicare Part B is the medical insurance portion of Original Medicare. It pays for services you receive from doctors and hospitals when you are not admitted as an overnight patient — things like office visits, lab work, X-rays, physical therapy, and ambulance transport. Part B also covers certain preventive care at no cost to you, such as annual wellness visits and cancer screenings.

Part B is optional, but most people who have Part A enroll in it. You pay a monthly premium for Part B (the amount changes each year based on your income), and you also pay a share of the cost when you use a service — typically a copay or coinsurance after you meet your annual deductible.

Key Takeaways

  • Part B covers doctor office visits, lab tests, imaging, outpatient surgery, and emergency room care when you are not admitted to the hospital overnight.
  • Preventive services covered at no cost include annual wellness visits, cancer screenings, cardiovascular screenings, and diabetes screenings.
  • You pay a monthly premium for Part B, plus a deductible and coinsurance or copays when you use covered services.
  • Part B does not cover routine dental, vision, hearing aids, or long-term care — you may need separate coverage or out-of-pocket payment for these.

Doctor Visits and Outpatient Services

Part B covers visits to your primary care doctor, specialists, and other healthcare providers such as nurse practitioners and physician assistants. It pays for office visits, telehealth appointments, and urgent care visits when you need same-day care but are not admitted to the hospital.

Outpatient hospital services are also covered — this includes emergency room visits, observation stays (where you are monitored but not formally admitted), and outpatient surgery or procedures performed in a hospital setting. If you go to the emergency room and are then admitted to the hospital as an inpatient, Part A covers the hospital stay itself, while Part B covers the emergency room evaluation.

Part B also covers mental health services, including therapy and psychiatric visits, at the same rate as other doctor visits. Substance use disorder treatment is covered as well.

Diagnostic Tests and Imaging

Laboratory tests ordered by your doctor — such as blood work, urinalysis, and pathology tests — are covered by Part B. Imaging services including X-rays, ultrasounds, CT scans, and MRI scans are covered when medically necessary and ordered by your doctor.

Electrocardiograms (EKGs), stress tests, and other cardiac diagnostic procedures are covered. Part B also pays for bone density scans (DEXA scans) to screen for osteoporosis, and for sleep studies if your doctor orders one to diagnose sleep apnea.

Preventive Care at No Cost

Part B covers certain preventive services with no copay or coinsurance, meaning you pay nothing out of pocket for these visits and screenings. Your annual wellness visit — a comprehensive health assessment with your doctor — is covered in full. This visit does not include a physical exam in the traditional sense; instead, your doctor reviews your health history, current medications, and risk factors.

Cancer screenings covered at no cost include mammograms for breast cancer, colonoscopies for colorectal cancer, and Pap tests for cervical cancer (if you have a cervix). Cardiovascular screenings such as blood pressure checks and cholesterol tests are covered. Diabetes screenings and abdominal aortic aneurysm screenings are also included.

Flu shots, pneumonia vaccines, and shingles vaccines (Shingrix) are covered at no cost. Hepatitis B and COVID-19 vaccines are covered as well. Bone density screening is covered once every two years for women over 65 and men over 70 at risk for osteoporosis.

Therapy and Rehabilitation Services

Part B covers physical therapy, occupational therapy, and speech-language pathology when ordered by your doctor and medically necessary. These services help you regain function after surgery, injury, or illness. Cardiac rehabilitation programs following a heart attack or heart surgery are covered, as are pulmonary rehabilitation programs for chronic lung disease.

Home health services — skilled nursing care, physical therapy, or occupational therapy provided in your home — are covered by Part B when you are homebound and your doctor orders them. You do not need a hospital stay first to receive home health services under Part B.

Durable Medical Equipment and Supplies

Part B covers durable medical equipment (DME) such as wheelchairs, walkers, canes, crutches, hospital beds, oxygen equipment, and continuous positive airway pressure (CPAP) machines. You typically pay 20 percent coinsurance for DME after meeting your deductible, and the equipment must be ordered by your doctor.

Diabetic supplies including glucose monitors, test strips, lancets, and insulin pumps are covered. Ostomy supplies and urological supplies are covered as well. Prosthetics and orthotics — artificial limbs, braces, and similar devices — are covered when medically necessary.

What Part B Does Not Cover

Part B does not cover routine dental care, dentures, dental implants, or tooth extractions. Vision care including routine eye exams, eyeglasses, and contact lenses are not covered (though one pair of eyeglasses or contact lenses after cataract surgery is covered). Hearing aids and hearing exams are not covered by Part B.

Long-term care in a nursing home or assisted living facility is not covered by Part B or Part A. Cosmetic surgery is not covered unless it is reconstructive following an injury or illness. Routine foot care, including nail trimming and callus removal, is not covered unless you have diabetes or a related condition.

Certain services require that you see a doctor who accepts Medicare assignment — meaning they agree to accept Medicare's approved amount as full payment. If you see an out-of-network provider who does not accept Medicare, you may owe more out of pocket.

How You Pay for Part B Services

You pay a monthly premium for Part B, which is deducted from your Social Security check if you receive benefits. The standard premium amount changes each year; if your income is higher, you may pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA).

After you pay your premium, you also have an annual deductible — the amount you must pay out of pocket before Part B starts to pay. Once you meet the deductible, you typically pay 20 percent coinsurance for most services, meaning Medicare pays 80 percent and you pay 20 percent. Some preventive services have no copay or coinsurance, as noted above.

If you have a Medigap (supplemental insurance) or Medicare Advantage plan, that plan may cover some or all of your coinsurance and deductible, reducing your out-of-pocket costs.

Frequently Asked Questions

Do I have to enroll in Part B when I turn 65?

Part B is optional, but if you delay enrollment without a valid reason, you may pay a permanent penalty on your premium. You have a seven-month Initial Enrollment Period centered on your 65th birthday to enroll without penalty. If you have employer health insurance when you turn 65, you may be able to delay Part B enrollment without penalty.

What is the difference between Part B and Part D?

Part B covers doctor visits, tests, and outpatient care. Part D is prescription drug coverage and is separate — it covers medications your doctor prescribes. You enroll in Part D through a private insurance company, not directly through Medicare.

Does Part B cover telehealth visits?

Yes, Part B covers telehealth visits with doctors and other providers who accept Medicare. You pay the same copay or coinsurance as you would for an in-person visit. Your provider must be enrolled in Medicare and use an approved telehealth platform.

Will Part B cover my annual physical exam?

Part B covers an annual wellness visit, which is a health assessment and risk evaluation. This is different from a traditional physical exam with blood pressure checks and a full body examination. If your doctor performs additional services during the visit, you may owe additional copays or coinsurance for those services.

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

If a doctor does not accept Medicare assignment, you may owe the full cost of the visit out of pocket. Some doctors are "non-participating" but still accept Medicare; they can charge up to 15 percent more than Medicare's approved amount. Before scheduling an appointment, ask whether the provider accepts Medicare and at what rate.