Medicare Part B covers doctor visits, lab tests, imaging, outpatient surgery, and preventive care — but not dental, vision, or hearing aids

Medicare Part B is the medical insurance piece of Original Medicare. It pays for services from doctors, hospitals, clinics, and other providers when you receive care outside a hospital bed. Part B covers the visit itself, the tests ordered during that visit, and most procedures done in an outpatient setting. It does not cover routine dental work, eyeglasses, hearing aids, or long-term care in a nursing home.

Part B is optional, but most people who have Part A (hospital insurance) also sign up for Part B. If you delay Part B after you first become may be able to access, you may pay a higher monthly premium for life. The monthly premium changes each year; you can find the current amount on Medicare.gov or your Social Security statement.

Key Takeaways

  • Part B pays 80 percent of the cost for most doctor visits and outpatient services after you meet your annual deductible; you pay the remaining 20 percent.
  • Preventive services like annual wellness visits, cancer screenings, and vaccinations are covered at no cost to you when you see a doctor who accepts Medicare.
  • Part B does not cover dental cleanings, routine eye exams, hearing aids, or services from providers who do not accept Medicare assignment.
  • You must enroll in Part B during your initial enrollment period or face a permanent premium penalty if you sign up later.

What Part B Pays For: Doctor Visits and Outpatient Services

Part B covers visits to your primary care doctor, specialists, and urgent care clinics. It pays for the doctor's time, the examination, and any tests ordered during that visit — such as blood work, urinalysis, or an EKG. If your doctor refers you to a specialist, Part B covers that visit too. The insurance pays 80 percent of the approved amount after you have paid your annual deductible (which varies by year); you are responsible for the remaining 20 percent, called coinsurance.

Outpatient procedures — surgery, injections, or imaging done in a hospital outpatient department or an ambulatory surgery center — are covered under Part B. This includes colonoscopies, cataract surgery, joint injections, and biopsies. Part B also covers mental health services, including therapy and psychiatric visits, at the same 80/20 split after your deductible.

Durable medical equipment such as wheelchairs, walkers, oxygen tanks, and diabetic testing supplies are covered under Part B. Your doctor must order the equipment, and you typically pay 20 percent of the approved cost after meeting your deductible. Home health services — nursing care, physical therapy, or occupational therapy provided in your home — are also covered when ordered by a doctor and deemed medically necessary.

Preventive Services Covered at No Cost

Medicare Part B covers certain preventive services without charging you a copay, coinsurance, or deductible — but only when you see a doctor who accepts Medicare assignment. These services include an annual wellness visit (a check-up focused on your overall health and prevention), blood pressure screening, cholesterol screening, and diabetes screening.

Cancer screenings covered under Part B include mammograms for breast cancer, colonoscopies for colorectal cancer, and Pap tests for cervical cancer. Bone density scans (DEXA scans) are covered for people at risk of osteoporosis. Vaccinations such as the flu shot, pneumonia vaccine, and shingles vaccine are covered at no cost. Abdominal aortic aneurysm screening is covered for men aged 65 to 75 who have ever smoked.

Cardiovascular disease screening, including an EKG or stress test, is covered once every five years. Colorectal cancer screening methods — colonoscopy, sigmoidoscopy, or fecal occult blood test — are covered based on your age and risk factors. The exact list of covered preventive services can change; check Medicare.gov for the current list.

What Part B Does Not Cover

Part B does not cover routine dental work, including cleanings, fillings, root canals, or dentures. Routine eye exams and eyeglasses are not covered. Hearing aids and hearing exams are not covered, though some hearing tests ordered by a doctor as part of a medical evaluation may be. Cosmetic surgery is not covered unless it is reconstructive surgery following an injury or illness.

Long-term care in a nursing home, assisted living facility, or custodial care is not covered by Part B. Prescription drugs are not covered under Part B (they fall under Part D). Acupuncture, chiropractic care, and massage therapy are generally not covered, though acupuncture for chronic lower back pain has limited coverage under specific conditions.

Services from providers who do not accept Medicare assignment may result in higher out-of-pocket costs. If a doctor is a non-participating provider, they can charge up to 15 percent more than the Medicare-approved amount, and you pay the difference. Services outside the United States are not covered, except in limited cases involving Canada or Mexico when you are traveling directly between parts of the United States.

How Much You Pay: Deductibles and Coinsurance

Part B has an annual deductible that you must pay out of pocket before Part B begins to pay. Once you meet the deductible, Part B covers 80 percent of the approved cost for most services, and you pay 20 percent coinsurance. The deductible amount changes each year; check your Medicare materials or Medicare.gov for the current year's amount.

If you see a doctor who accepts Medicare assignment, your costs are limited to the deductible and 20 percent coinsurance on the Medicare-approved amount. If you see a non-participating provider, you may owe more. Some services, such as preventive care, have no deductible and no coinsurance when provided by a participating provider.

Part B also has a monthly premium, which is deducted from your Social Security check or paid directly to Medicare. The premium amount depends on your income; higher earners pay more through an income-related adjustment. If you have a Medigap or Medicare Advantage plan, that plan may cover some or all of your Part B deductible and coinsurance.

Finding Doctors and Providers Who Accept Medicare

Not all doctors accept Medicare, and not all who do accept it accept new Medicare patients. Before scheduling an appointment, confirm that the doctor accepts Medicare assignment. You can search for participating doctors on Medicare.gov using the "Care Provider Search" tool, or call the provider's office directly and ask if they accept Medicare.

Participating providers agree to accept the Medicare-approved amount as payment in full (except for your deductible and coinsurance). Non-participating providers may charge more, and you are responsible for the difference. If a provider does not accept Medicare at all, Medicare will not pay anything toward the visit, and you pay the full cost.

Urgent care clinics, retail clinics in pharmacies, and telehealth providers may or may not accept Medicare. Ask before your visit to avoid surprise bills. If you receive care from a non-participating provider without knowing they do not accept Medicare, you can file a complaint with Medicare and may be able to dispute the bill.

Part B and Other Medicare Coverage

Part B works alongside Part A (hospital insurance). Part A covers inpatient hospital stays, skilled nursing facility care, and hospice. Part B covers the outpatient and doctor services. Together, they form Original Medicare. If you have a Medicare Advantage plan (Part C) instead, that plan covers both Part A and Part B services, usually with different rules and provider networks.

Part D (prescription drug coverage) is separate from Part B and covers medications. Part B does not cover most outpatient drugs, though some drugs administered in a doctor's office or hospital outpatient department are covered under Part B. Medigap plans supplement Original Medicare by covering some of the costs that Part A and Part B do not, such as deductibles and coinsurance.

Frequently Asked Questions

Do I have to pay anything for preventive services under Part B?

No, preventive services such as annual wellness visits, cancer screenings, and vaccinations are covered at no cost when you see a doctor who accepts Medicare assignment. You pay nothing for the deductible or coinsurance on these services. However, if you see a non-participating provider, you may owe more.

What happens if I do not sign up for Part B when I first become may be able to access?

If you delay Part B enrollment without a valid reason, you will pay a higher monthly premium for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each full year you were may be able to access but did not enroll. This penalty is permanent, even if you sign up later.

Does Part B cover telehealth visits?

Yes, Part B covers telehealth visits with doctors who accept Medicare. Telehealth services are covered at the same rate as in-person visits — you pay your deductible and 20 percent coinsurance. However, not all providers offer telehealth, and some may have restrictions on which services can be provided remotely.

Can I use Part B to see any doctor I want?

You can see any doctor who accepts Medicare, but not all doctors do. If you see a non-participating provider, you may pay more out of pocket. If you have a Medicare Advantage plan instead of Original Medicare, you must use doctors in that plan's network, with limited exceptions for emergencies.

Does Part B cover physical therapy?

Yes, Part B covers physical therapy, occupational therapy, and speech-language pathology when ordered by a doctor and deemed medically necessary. You pay your deductible and 20 percent coinsurance. There are limits on the number of visits covered per year, though exceptions can be made if your doctor documents medical necessity.