Medicare Part B — what it actually covers.
Part B pays for doctor visits, outpatient hospital services, preventive care, durable medical equipment, and some home health.
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Doctor and specialist visits
Part B covers medically necessary services from doctors and most specialists. After your annual deductible, you typically pay 20% coinsurance unless you have a Medicare Supplement that covers the gap.
Outpatient hospital and surgery
Outpatient hospital services like ER visits (that do not result in admission), ambulatory surgery, observation status, lab work, and imaging are Part B services. Watch out for "observation status" — it is Part B, not Part A.
Preventive care
Many preventive services are covered at $0 if you go to a provider who accepts assignment. These include the annual wellness visit, mammograms, colonoscopies, flu shots, and screenings for diabetes, depression, and cardiovascular disease.
Durable medical equipment (DME)
Wheelchairs, walkers, oxygen, hospital beds, and similar equipment are covered when medically necessary. You typically pay 20% after the Part B deductible.
What Part B does not cover
- Most prescription drugs (you need Part D)
- Routine dental, vision, hearing
- Long-term custodial care
- Cosmetic procedures