Medicare Part B is one of Medicare’s four main parts.

Medicare Part B covers the bulk of your medical needs beyond hospitalization and prescription drugs, including:

• Doctor visits or appointments with other health care providers, including some doctor services when hospitalized.
• Diabetes care, including education, certain equipment, prevention programs and screenings.
• Diagnostic tests, including CT scans, electrocardiograms, MRIs and X-rays.
• Durable medical equipment, such as wheelchairs and walkers, that your doctor prescribes for use in your home.
• Emergency department and outpatient surgery center services, as well as other outpatient hospital services.
• Some health programs, such as cardiac rehabilitation, obesity counseling and smoking cessation.
• Laboratory services, such as blood and urine tests.
• A limited number of prescription drugs that you usually don’t administer yourself, such as insulin from an external insulin pump that’s not disposable. Insulin you administer yourself is covered under Medicare Part D instead.
• Outpatient mental health services.
• Outpatient physical therapy, occupational therapy and speech and language pathology services.
• Preventive care, such as flu shots and mammograms, to help avert illness or detect it at an early stage. Many preventive services are covered without deductibles or copayments; however, some vaccinations, such as the shingles vaccine, are covered under Part D instead.
• A Welcome to Medicare checkup and the annual wellness visit, which are covered in full without deductibles or copayments, unless additional tests are ordered.
• Even though Part B covers many doctor services, it doesn’t cover everything. Part B generally doesn’t cover routine dental, hearing and vision care.
• What’s more, care not considered medically necessary, such as elective cosmetic surgery, isn’t covered, either. Chiropractor and acupuncture visits are paid for only if you meet very specific criteria, and Part B doesn’t cover medical services outside the United States, except in rare circumstances.

What doesn’t Medicare Part B pay for? #

Part B doesn’t cover everything, including several doctor and outpatient services.

• Care not considered medically necessary, such as elective cosmetic surgery or weight loss procedures, unless you meet certain conditions associated with morbid obesity
• 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.

Part B covers only manual manipulation of the spine considered medically necessary to correct a subluxation, a dislocation or misalignment of the vertebrae. It covers acupuncture only if you’ve experienced low back pain for at least 12 weeks.

• Dental cleanings, exams and X-rays, as well as most dental care and procedures
• Gym memberships and general fitness benefits
• Medical services outside the United States, except under rare circumstances
• Most prescription drugs. Part D covers many of the doctor-prescribed medicines you take yourself as well as insulin you inject yourself and related supplies. Part B does cover drugs administered in a doctor’s office or outpatient clinic, such as most infused and injectable medications, and those delivered through durable medical equipment, including insulin from an external infusion pump that you reuse.
• Routine eye exams, eyeglasses and contact lenses. Part B covers eye exams to check for certain conditions, such as glaucoma and diabetic retinopathy if you’re considered at high risk. It also covers one set of glasses or contact lenses if you have cataract surgery that implants an intraocular lens.
• Routine foot care, but it covers therapeutic shoes and accompanying orthotic inserts and some foot exams for people with diabetes
• Routine hearing tests, hearing aids and exams for fitting them
• Some vaccinations, such as the shingles vaccine that Part D covers. Others, including flu, hepatitis B and pneumonia shots, are a Part B free preventive service.

How much does Medicare Part B cost? #

Even though Medicare Part B covers many of your expenses for doctor services and outpatient care, you will have some out-of-pocket costs.

Part B premiums. Most people pay $174.70 a month in 2024 for Medicare Part B premiums. People who are single with an adjusted gross income of more than $103,000 or married filing jointly with income greater than $206,000 pay a high-income surcharge (officially called the Income-Related Monthly Adjustment Amount, or IRMAA) with premiums ranging from $244.60 to $594.00 a month, depending on income level.

Premiums are based on your last tax return on file, which is usually 2022 income for 2024 premiums.

If you don’t enroll in Medicare when you’re first eligible or qualify for a special enrollment period to sign up later, you may have to pay a late enrollment penalty, which is added to your Part B premiums for as long as you have the coverage.

Deductible. You must pay a $240 deductible in 2024 before most Part B coverage begins. However, the Welcome to Medicare checkup, the annual wellness visit and some preventive care are not subject to any deductible or coinsurance unless your doctor orders additional tests. 

Coinsurance. After paying the deductible, you’ll generally pay 20 percent of the Medicare-approved amount for most doctor and outpatient services and for durable medical equipment.

Extra charges. Doctors who don’t accept assignment, which means they don’t agree to take the amount Medicare approves for their services, can charge up to 15 percent above the Medicare-approved amount for a service, which you would have to pay in addition to the 20 percent copayment for doctor services.