Medicare Part B covers doctor visits, outpatient care, and medical equipment — but not everything

Medicare Part B is the insurance that pays for services outside a hospital: your doctor's office visit, lab work, X-rays, physical therapy, ambulance transport, and durable medical equipment like wheelchairs or oxygen. It does not cover hospital stays (that is Part A), prescription drugs (that is Part D), or long-term care. Part B has a monthly premium, a yearly deductible, and coinsurance — you pay a percentage of the cost after you meet the deductible.

The line between what Part B covers and what it does not is not always obvious. A colonoscopy is covered. A routine eye exam is not. Diabetes management supplies are covered; most dental work is not. This section walks through the main categories so you know what to expect when you get a bill.

Key Takeaways

  • Part B covers doctor office visits, lab tests, imaging, outpatient surgery, and mental health services at any provider who accepts Medicare.
  • Durable medical equipment like walkers, oxygen tanks, and hospital beds is covered if your doctor orders it and the supplier is Medicare-approved.
  • Part B does not cover routine dental, vision, or hearing care, though it covers some services if they are medically necessary (like surgery for a broken jaw).
  • You pay a monthly premium for Part B, plus a yearly deductible and coinsurance on most services — the exact amounts change each year.
  • Coverage depends on whether the provider accepts Medicare assignment; always check before scheduling to avoid surprise bills.

Doctor visits and outpatient services Part B definitely covers

Part B pays for visits to your primary care doctor, specialists, and urgent care clinics. It covers the office visit itself, any tests the doctor orders in the office (like an EKG or blood draw), and follow-up visits. If your doctor refers you to a specialist — a cardiologist, rheumatologist, or orthopedist — Part B covers that visit too, as long as the specialist accepts Medicare.

Outpatient surgery and procedures are covered: colonoscopies, cataract surgery, joint injections, and biopsies performed in a hospital outpatient department or surgery center. Part B also covers diagnostic imaging — X-rays, CT scans, ultrasounds, and MRIs — when ordered by your doctor. Lab work and blood tests are covered. Mental health services, including therapy and psychiatry visits, are covered at the same rate as physical health visits.

The key requirement is that the provider must accept Medicare. If they do not, you may owe the full bill. Always ask before your appointment whether the provider accepts Medicare assignment, which means they agree to accept Medicare's payment as full payment (except for your deductible and coinsurance).

Durable medical equipment and supplies

Part B covers durable medical equipment — items that last longer than a few months and serve a medical purpose. This includes wheelchairs, walkers, canes, crutches, hospital beds, oxygen tanks and concentrators, CPAP machines, diabetic testing supplies, and wound care supplies. The equipment must be ordered by your doctor and supplied by a Medicare-approved supplier.

You typically pay 20 percent coinsurance after you meet your deductible. Some items, like diabetic test strips and lancets, may have limits on how many you can receive per month — your doctor's prescription must match those limits or the supplier will not deliver the full amount.

If you need equipment, ask your doctor to write an order and specify which supplier you prefer, or ask for a list of Medicare-approved suppliers in your area. Ordering from a non-approved supplier means Part B will not pay, and you will owe the full cost.

Preventive care and screenings Part B covers

Part B covers many preventive services at no cost to you — meaning you do not pay coinsurance or a copay, though you still pay the monthly premium. These include annual wellness visits with your primary care doctor, mammograms, colorectal cancer screening (colonoscopy, sigmoidoscopy, or stool tests), prostate cancer screening, bone density scans, cardiovascular screening, diabetes screening, and pneumonia and flu shots.

Preventive services are covered only when they are age-appropriate and meet Medicare's guidelines. For example, a colonoscopy for screening is free, but a colonoscopy to treat a known condition is not — you pay coinsurance on the treatment colonoscopy. If your doctor finds something during a preventive visit and performs a treatment, you may owe coinsurance on the treatment portion.

What Part B does not cover

Part B does not cover routine dental care, including cleanings, fillings, root canals, and dentures. It does not cover routine eye exams or glasses, though it covers one pair of glasses or contact lenses after cataract surgery. It does not cover routine hearing exams or hearing aids. These exclusions are firm — even if you have Part B, you need separate dental, vision, and hearing insurance or you pay out of pocket.

Part B does not cover long-term care in a nursing home or assisted living facility. It does not cover custodial care — help with bathing, dressing, or eating — unless it is part of skilled nursing or rehabilitation. It does not cover most cosmetic procedures. It does not cover acupuncture, massage therapy, or chiropractic care (with rare exceptions for specific conditions). It does not cover most over-the-counter medications or prescription drugs — that is Part D's role.

Part B also does not cover services from providers who do not accept Medicare, unless you have a specific agreement with the provider beforehand. If a provider is not Medicare-approved, you are responsible for the full bill.

How much you pay for Part B coverage

Part B has three costs: a monthly premium, a yearly deductible, and coinsurance. The monthly premium varies based on your income — higher earners pay more. The yearly deductible is the amount you must pay out of pocket before Part B starts paying. Once you meet the deductible, you typically pay 20 percent coinsurance on most services; Part B pays the other 80 percent.

Some services, like preventive care and mental health visits, have no coinsurance — Part B covers them fully after you pay the premium. Others, like durable medical equipment, have a 20 percent coinsurance. Hospital outpatient services may have different cost-sharing rules.

The exact dollar amounts for the premium and deductible change each year. Your Social Security statement or Medicare card will show your current premium. You can find the current deductible on Medicare.gov or by calling Medicare at 1-800-MEDICARE.

Medigap and Medicare Advantage: how they change Part B coverage

If you have Medigap (supplemental insurance), it pays some or all of your Part B coinsurance and deductible, depending on which Medigap plan you choose. This means you may pay little or nothing out of pocket for covered services. Medigap does not change what Part B covers — it just reduces your share of the cost.

If you have Medicare Advantage (Part C), you have a different insurance plan that replaces Part A and Part B. Medicare Advantage plans cover the same services as Part B, but with different costs and networks. You may have copays instead of coinsurance, and you may be required to use in-network providers. Medicare Advantage plans often include dental, vision, and hearing benefits that Original Medicare does not.

If you are unsure whether you have Original Medicare with Part B, Medigap, or Medicare Advantage, check your insurance card or call the number on it.

Frequently Asked Questions

Does Part B cover my annual physical exam?

Yes. Part B covers one annual wellness visit with your primary care doctor at no cost to you (beyond your monthly premium). This visit includes a health assessment, screening for common conditions, and a care plan. If your doctor performs additional services during that visit — like treating a condition — you may owe coinsurance on the treatment portion.

Is my prescription medication covered under Part B?

No. Prescription drugs are covered under Part D, a separate insurance you must enroll in. Part B covers some medications given in a doctor's office or hospital outpatient setting — like chemotherapy or IV antibiotics — but not pills you take at home. You need Part D coverage for those.

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

If the doctor does not accept Medicare assignment, you may owe the full bill. Some doctors accept Medicare but do not accept assignment, meaning they can charge you more than Medicare's approved amount. Always ask before scheduling whether the provider accepts Medicare assignment.

Does Part B cover physical therapy?

Yes, if your doctor orders it. Part B covers physical therapy in an outpatient setting — a clinic, hospital, or your home. You pay 20 percent coinsurance after you meet your deductible. Medicare limits the number of visits per year, though your doctor can request more if medically necessary.

Are mental health services covered the same as physical health services?

Yes. Part B covers psychiatry, therapy, and counseling at the same rate as doctor visits — you pay 20 percent coinsurance after your deductible. Mental health parity means insurance companies must treat mental and physical health the same way.