Medicare Part B—What It Covers and What It Costs

Medicare Part B is an essential component of the Medicare program, providing crucial health coverage for a wide range of medical services. Understanding what Part B covers and its associated costs can help you make informed decisions about your healthcare.

What Medicare Part B Covers

Medicare coverage works with Medicare-approved providers, including doctors, hospitals, hospice centers and nursing care facilities.

Medicare Part B primarily focuses on outpatient care and preventive services. Here’s a breakdown of its coverage:

• Doctor visits—Part B covers visits to your Medicare-approved primary care physician and specialists for diagnosis and treatment.

• Preventive services—Annual wellness visits, vaccinations and screenings (such as mammograms and colonoscopies) are included to help detect health issues.

• Outpatient hospital services—Emergency room visits, outpatient surgery and certain inpatient services at a Medicare-approved hospital are covered under Part B.

• Diagnostic tests—Laboratory tests, X-rays and other imaging services are part of your coverage.

• Durable medical equipment—Medicare Part B helps cover the cost of medical equipment like wheelchairs, walkers and oxygen equipment.

• Mental health services—Counseling, therapy sessions and certain inpatient mental health care are typically included.

What Medicare Part B Does Not Cover

While Part B offers extensive coverage, there are certain limitations. Here’s what is not included:

• Long-term care—Medicare does not cover extended stays in nursing homes or assisted living facilities.

• Cosmetic procedures—Elective cosmetic surgeries are not covered unless deemed medically necessary.

• Most dental and vision care—Routine dental and vision services, such as teeth cleanings and glasses, are typically excluded.

Costs Associated with Medicare Part B

Understanding the costs of Medicare Part B is essential for budgeting your healthcare expenses. Most beneficiaries pay a standard premium, which can vary based on income.

You must pay an annual deductible before Medicare begins to cover costs. After meeting your deductible, you typically pay 20% of the Medicare-approved amount for most services, while Medicare pays the remaining 80%.

Contact Us

Contact Reinholdt & O’Harra Insurance in Ashland, Oregon, for more information about your Medicare options.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.