What items are covered under Medicare Part B?
Asked by: Ricky Osinski Jr. | Last update: June 12, 2025Score: 4.7/5 (46 votes)
What is covered in Medicare Part B?
- Services from doctors and other health care providers.
- Outpatient care.
- Home health care.
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
What expenses are covered by Medicare Part B?
- Medically necessary services: Services or supplies that meet accepted standards of medical practice to diagnose or treat your medical condition.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage when treatment is likely to work best.
What's not covered under Medicare Part B?
Medicare Part B does not pay for some services that fall under the coverage of other parts. Examples include inpatient hospital services, which Part A funds, and most prescription medications, which Part D funds. Medicare regularly evaluates which services Part B will cover.
Which item is generally covered under Medicare Part B?
Medicare Part B covers outpatient prescription drugs and biologicals (referred hereafter as drugs) under certain conditions, for example, drugs provided as part of (or incident to) a physicians' service, and drugs furnished for use with covered durable medical equipment.
What does Medicare Part B Cover?
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
Why is Social Security no longer paying Medicare Part B?
There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.
What service is not paid under Medicare Part B?
We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.
What does Medicare B pay for for seniors?
Part B helps pay for covered medical services and items when they are medically necessary. Part B also covers some preventive services like exams, lab tests, and screening shots to help prevent, find, or manage a medical problem. Cost: If you have Part B, you pay a Part B premium each month.
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
Do I really need Medicare Part B?
Part B helps cover medically necessary services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. Part B also covers many preventive services. Part B coverage is your choice. However, you need to have Part B if you want to buy Part A.
Does Medicare Part B cover dental?
For Part B-covered dental services, you pay 20% of the Medicare-approved amount after you meet the Part B deductible. If you get the covered service in an outpatient hospital or other facility setting, you'll also pay a copayment to the facility.
What medical expenses are covered by Medicare Part B?
Medicare Part B covers physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
What are the top 5 medicare supplement plans?
💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.
What is the 80/20 rule in Medicare?
The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs. The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR.
What does part B not cover?
Part B doesn't cover everything, including several doctor and outpatient services. Chiropractor or acupuncture visits, unless you meet very specific criteria. It won't cover regular maintenance or preventive chiropractic visits or treatments to other parts of the body.
What drugs does Medicare B pay for?
- Vaccinations.
- Some antigens.
- Blood clotting factors.
- Injectable and infused drugs.
- Injectable osteoporosis drugs.
- Erythropoiesis-stimulating agents.
- Oral end-stage renal disease drugs.
- Transplant and immunosuppressive drugs.
Is Medicare Part B free at age 65?
Medicare Part A (hospital insurance) is free for almost everyone. You have to pay a monthly premium for Medicare Part B (medical insurance). If you already have other health insurance when you become eligible for Medicare, you may wonder if it's worth the monthly premium costs to sign up for Part B.
Which item is not covered under Medicare Part B?
Medicare Part B typically doesn't cover routine vision, hearing, and dental care, regular foot care, and aids like eyeglasses, contact lenses, and hearing aids. But Part B policies often change, so it's important to verify coverage details with Medicare.
What blood tests does Medicare not cover for seniors?
It's important to know that Medicare won't cover any blood test if it isn't medically necessary. If you seek a blood test on your own, it's unlikely you'll get it covered. Tests not covered may include those for employment purposes, wellness screenings, or routine monitoring without medical necessity.
Does everyone pay $170 for Medicare Part B?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Who qualifies for an extra $144 added to their Social Security?
To qualify for a Medicare giveback benefit, you must be enrolled in Medicare Part A and B. You must be responsible for paying the Part B Premiums; you should not rely on state government or other local assistance for your Part B premiums.
Why would you decline Medicare Part B?
In most cases, you should only decline Part B if you have group health insurance from an employer you or your spouse is actively working at, and that insurance is primary to Medicare, meaning it pays before Medicare does.