Medicare Part B is the medical insurance part of Medicare that covers medically necessary services and preventive services not covered by Part A. It helps pay for outpatient care such as doctor visits, outpatient tests, durable medical equipment, ambulance services, and some home health care. After meeting an annual deductible, Part B generally covers 80% of approved charges, and the beneficiary is responsible for the remaining 20% coinsurance.
Key Coverage in Medicare Part B
- Physicians’ services including office visits
- Outpatient care and hospital outpatient services
- Diagnostic tests like X-rays and lab tests
- Durable medical equipment (wheelchairs, oxygen, prosthetics)
- Home health care services
- Ambulance services
- Preventive services including screenings, vaccines (e.g., flu, pneumonia), and cancer screenings
- Some physical, occupational, and speech therapies
Enrollment and Costs
- Part B is usually optional but automatic for most people receiving Social Security or Railroad Retirement Board benefits.
- Enrollees pay a monthly premium with a standard rate around $185 per month in 2025.
- There is an annual deductible (about $257 in 2025), after which Part B pays 80% of the Medicare-approved amount.
- If a provider does not accept Medicare assignment, patients may pay more but federal law limits extra charges to 115% of the Medicare-approved amount.
What Is Not Covered by Part B?
- Routine physical exams
- Most prescription drugs (covered under Medicare Part D if enrolled)
- Dental care and dentures
- Vision care including eyeglasses
- Hearing aids
- Long-term care and cosmetic surgery
This coverage helps fill gaps left by Medicare Part A, especially for outpatient and physician services, making it a crucial component of Original Medicare.
