A Detailed Look at What’s Covered Under Medicare Part B

Original Medicare, provided by the federal government, consists of two parts: Medicare Part A and Medicare Part B. 

Medicare Part A is hospital insurance that helps cover inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. 

Medicare Part B is medical insurance that helps cover outpatient care, such as doctor’s visits and lab testing. It also covers preventive care such as flu shots, colonoscopies, mammograms, and yearly wellness visits.

Let’s take a closer look at what Medicare Part B covers and what it doesn’t cover.  

What Medicare Part B covers 

Medicare Part B helps cover medically necessary services and preventive services, including doctor visits, outpatient care, some home health services, and durable medical equipment (DME). 

Preventive services: Preventive services help detect health problems early and may include screenings, vaccines, counseling, and yearly wellness visits. Medicare Part B covers many preventive services, and you usually pay nothing for most of them when the provider accepts Medicare assignment. 

Read our article about Medicare coverage for preventive care and screenings to learn more. 

Doctor/clinic care: Medicare Part B helps cover doctors’ services and other outpatient medical care, including many services provided in a physician’s office, clinic, or hospital outpatient setting. 

Home health services: Part B may cover certain home health services when eligibility and coverage requirements are met, including part-time skilled care and some therapy services such as physical therapy. 

Durable medical equipment (DME): Medicare Part B may help cover certain medically necessary medical equipment for use in your home. This can include items like walkers, wheelchairs, hospital beds, CPAP machines, and oxygen equipment when a doctor or other health care provider orders them and Medicare coverage requirements are met. Depending on the item, Medicare may cover rental or purchase of the equipment, or give you a choice between the two. 

Read our guide on durable medical equipment Medicare coverage to learn more. 

Ambulance services: Medicare Part B may cover emergency or non-emergency ambulance transportation when medically necessary (that is, when using any other vehicle could endanger your health and the ambulance takes you to the nearest appropriate medical facility that can provide the care you need).¹ In some emergencies, Medicare may also cover ambulance transportation by airplane or helicopter if you need rapid transport that ground transportation cannot provide. 

Mental Health & Substance Abuse Treatment: Medicare Part B covers a wide range of outpatient mental health services. It may also cover partial hospitalization, intensive outpatient program services, and mental health services provided as part of substance use disorder treatment when Medicare coverage requirements are met. 

Read our guide on Medicare mental health coverage to learn more. 

Certain Outpatient Drugs: Medicare Part B covers only a limited number of outpatient prescription drugs under certain conditions, generally when the drugs are administered in a doctor’s office or outpatient clinic or used with covered durable medical equipment.² Examples can include some injectable or infused drugs, certain vaccines, allergy antigens, and some medications used with equipment such as infusion pumps or nebulizers. 

Medicare Part B may also cover clinical research when Medicare coverage criteria are met.³ 

What Medicare Part B does not cover 

Medicare Part B covers many services, but it does not cover everything. Some items and services not covered by Medicare include:⁴ 

• Routine eye exams 

• Hearing aids and fitting exams 

• Routine physical exams 

• Cosmetic surgery 

• Massage therapy 

• Most dental care 

  • Services such as cleanings, fillings, extractions, or items like dentures are not covered 

  • Some dental services closely related to certain services like heart valve repairs or replacement, organ transplants, cancer treatments, and dialysis for End-Stage Renal Disease (ESRD) may be covered by Medicare 

• Long-term care 

If you are unsure whether Medicare will cover a service, ask your doctor or provider why it is needed and check Medicare’s official coverage database for that test, item, or service. 

Medicare Part B costs 

Medicare Part B generally has a monthly premium, annual deductible and coinsurance once the deductible is met. In 2026, the annual deductible is $283, and the standard Part B monthly premium is $202.90, although those with higher incomes may pay more. After meeting the deductible, your coinsurance is 20% of the cost for approved services.  

To learn more about how your income impacts your monthly premium, read our article on Medicare Part B premiums for 2026. 

Frequently asked questions 

Q1. Do I have to pay for Medicare Part B? 

Yes. Most people pay a monthly premium for Medicare Part B, and Part B also has an annual deductible before Medicare begins paying its share for many covered services. After the deductible, you typically pay coinsurance for covered care. 

Q2. What does Medicare Part B cost per month? 

In 2026, the standard Medicare Part B monthly premium is $202.90. Some people pay more based on income-related monthly adjustment amounts, and these amounts are determined using tax information and filing status. 

Q3. Do I need both Part A and Part B? 

Many people choose to have both Part A and Part B because they cover different types of care. Part A generally covers inpatient hospital-related care, while Part B generally covers doctors’ services, outpatient care, preventive services, and certain medical equipment and supplies. 

Q4. Does Medicare Part B cover prescriptions? 

Medicare Part B covers only a limited number of outpatient prescription drugs under certain conditions, such as some drugs administered by a licensed provider in a clinical setting, certain drugs used with durable medical equipment, and specific vaccines or specialty medications that meet Medicare rules.² Most outpatient prescription drugs are generally covered under Part D rather than Part B. 

Q5. What does Medicare Part B not cover? 

Medicare Part B does not cover most outpatient prescription drugs and generally does not cover most routine dental, vision, and hearing care. To get coverage for those services, review other Medicare coverage  or private insurance options. Medicare Part D provides prescription drug plans, while private insurance plans or savings plans may help cover dental, vision or hearing services.  

For services that are approved under Medicare Part B, you are responsible for part of the costs. Medicare Part B does not cover the full cost of services. After meeting the deductible ($283 in 2026), your coinsurance is 20% of the Medicare-approved amount for services.    

Q6. How do I apply for Medicare Part B? 

You can sign up for Medicare through Social Security. If you’re already receiving certain Social Security benefits, you may be automatically enrolled in Part A and Part B. If not, you can generally enroll during one of the Medicare enrollment periods. 

Part B enrollment can be completed through Social Security either online or by submitting the required enrollment forms, depending on your situation. 

1. Online through Social Security, if eligible for the online enrollment path. 

2. By phone through Social Security at 1-800-772-1213. 

3. In person through a local Social Security office. 

4. By submitting Form CMS-40B when you already have part A or form CMS-L564 to provide proof of employment when you enroll in Part B. You can find those forms on Medicare.gov. 

Sources

 ¹ Medicare.gov. Ambulance services. Retrieved May 19, 2026, from www.medicare.gov/coverage/ambulance-services 

² Medicare.gov. Prescription drugs (outpatient). www.medicare.gov/coverage/prescription-drugs-outpatient  

³ Medicare.gov. Clinical research studies. Retrieved May 19, 2026, from www.medicare.gov/coverage/clinical-research-studies 

⁴ Medicare.gov. What’s not covered? Retrieved May 19, 2026, from www.medicare.gov/providers-services/original-medicare/not-covered  

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