What Does Medicare Part B Cover? Complete Services List

Medicare Part B shows up every month in your premium deduction. It covers doctor visits, preventive screenings that cost nothing out of pocket, equipment like wheelchairs and walkers, ambulance rides, and even some insulin—the details matter because they affect what lands in your pocket versus what lands in a bill you weren’t expecting.

Covers doctor visits: Outpatient care · Covers ambulance services: Yes · Covers durable medical equipment: Medically necessary · Covers preventive care: Screenings and visits · Covers mental health: Outpatient services

Key coverage details and costs for Medicare Part B are summarized in the table below.

What is included in Medicare Part B?

Medicare Part B covers medically necessary services and preventive services to diagnose, treat, or prevent illness (Medicare.gov). The two main categories break down like this:

Doctor visits

Part B covers physicians’ services, outpatient care, and visits to specialists (CMS). This includes annual wellness visits, diabetes care, and ongoing management of chronic conditions. Whether you see your primary care doctor for a check-up or get a referral to a cardiologist, those visits fall under Part B as long as you’re an outpatient.

Preventive care

Medicare covers annual mammograms for women age 40 and older with no Part B deductible (Center for Medicare Advocacy). Pap smears, pelvic exams, and clinical breast exams are covered every two years, or annually for those at high risk for cervical cancer, and the deductible is waived for these services too. Annual wellness visits also have no deductibles, copays, or coinsurance (BCBS). Other preventive services include cardiovascular screenings, diabetes screenings, and various vaccines.

Outpatient services

Part B covers outpatient hospital services, diagnostic tests like X-rays and MRIs, outpatient surgery, and cardiac rehabilitation (Anthem). Laboratory work ordered by your doctor and performed at an independent lab or hospital outpatient setting is also covered.

Durable medical equipment (DME)

Medicare Part B covers medically necessary durable medical equipment prescribed by a doctor for home use from a Medicare-approved supplier (Elder Law Answers). DME must be documented as medically necessary by your doctor, and both your doctor and the supplier must be enrolled in Medicare. Equipment covered includes wheelchairs, walkers, oxygen equipment, hospital beds, and prosthetic devices.

Medicare typically covers 80% of the approved amount for DME after the Part B deductible, with beneficiaries paying 20% coinsurance (Elder Law Answers). Suppliers participating in Medicare must accept assignment, limiting your charges to coinsurance and the deductible (Medicare.gov).

Mental health

Part B covers outpatient mental health services including visits with psychiatrists, psychologists, clinical social workers, and other mental health professionals. Partial hospitalization and intensive outpatient programs are also covered under certain conditions.

Ambulance services

Ambulance services are covered when medically necessary—meaning your condition requires transport by ambulance rather than other means. Part B covers emergency ambulance transport to the nearest appropriate facility, as well as non-emergency transport when specifically ordered by a doctor.

Clinical research

Part B helps cover the costs of clinical research studies, including items and services provided routine during qualifying clinical trials. This includes doctor visits, lab tests, and other procedures that would normally be covered under Part B.

Limited outpatient prescription drugs

Part B covers a 3-month supply of covered insulin for no more than $35 per month, or $105 total (Medicare.gov). This applies to insulin used with an insulin pump that is covered under Part B’s durable medical equipment benefit. Other drugs covered under Part B include injectable drugs administered by a doctor, some oral cancer drugs, and drugs used with durable medical equipment.

Does Medicare Part B pay 100%?

After you meet the Part B deductible, Medicare typically covers 80% of approved amounts for covered services (Elder Law Answers). You pay the remaining 20% coinsurance, and there is no annual out-of-pocket cap under Original Medicare Part B alone.

Deductibles and coinsurance

The annual deductible for Medicare Part B in 2026 is $283, an increase of $26 from $257 in 2025 (CMS). This deductible applies from January 1 to December 31 each calendar year. After you pay the deductible, 20% coinsurance applies to most services—for example, $20 on a $100 doctor visit (The Medicare Family).

Part B coinsurance is 20% after the deductible for approved services or items (NCOA). This applies to physician services, outpatient therapy, DME, and most other covered outpatient items. There are some exceptions where Medicare may pay more than 80%.

Preventive services exception

Preventive care like annual wellness visits and mammograms has no deductibles, copays, or coinsurance (BCBS). Many other preventive screenings—including colorectal cancer screenings, cardiovascular screenings, and diabetes screenings—are also covered at 100% with no deductible required.

The pattern: for routine preventive care, Part B is remarkably generous—zero out-of-pocket. For everything else, Medicare covers most of the cost, but the 20% you’re responsible for can still be significant. If you anticipate needing expensive outpatient care, a Medigap policy that covers Part B coinsurance may be worth the additional premium.

What’s not covered by Medicare Part B?

Part B has clear boundaries, and understanding what’s outside its scope prevents surprise bills and helps with planning.

Routine dental

Routine dental care—cleanings, fillings, extractions, dentures—is not covered by Part B. Medicare does not cover dental services performed in a dentist’s office under Original Medicare, with very limited exceptions for dental services that are integral to a covered procedure (such as jaw reconstruction after an accident).

Vision care

Routine eye exams for glasses or contacts are not covered. Part B covers cataract surgery and one pair of corrective lenses after cataract surgery, but routine eye exams and glasses are out-of-pocket expenses. Some Medicare Advantage plans (Part C) include routine vision coverage as an extra benefit.

Hearing aids

Medicare Part B does not cover hearing aids or routine hearing exams for fitting hearing aids. This is a significant gap for many seniors, as hearing aids can cost thousands of dollars. Some Part C plans include hearing aid coverage, and there are assistance programs for those with limited income.

Most prescription drugs

Part B covers very few retail prescription drugs—you’ll need Part D for that. Part B only covers drugs administered by a doctor in an outpatient setting, certain injectable drugs, and limited items like the $35 insulin cap (Medicare.gov). If you take regular medications by mouth at home, those fall under Part D, not Part B.

Long-term care

Medicare does not cover long-term custodial care in a nursing home or assisted living facility. Part A covers skilled nursing facility care under limited conditions following a hospital stay, but Part B does not cover ongoing custodial care (help with activities of daily living like bathing and dressing).

Cosmetic surgery

Elective cosmetic procedures are not covered unless they are reconstruction following injury or surgery for a medical condition. For example, breast reconstruction after mastectomy is covered, but facelifts and tummy tucks are not. For more information on Medicare Part B coverage, consult this close grip bench press guide.

How much does Medicare Part B cost?

Part B costs consist of a monthly premium, an annual deductible, and coinsurance for most services. Here is where the numbers stand for 2026.

Monthly premium

The standard monthly premium for Medicare Part B in 2026 is $202.90, up $17.90 from $185.00 in 2025 (CMS). Most people pay this standard premium, and the Social Security Administration notifies each beneficiary of their exact amount. High-income earners pay more: premiums for individuals with incomes at or above $391,000 reach up to $608.10 monthly in 2026 (CMS).

Most pay standard Part B premium of $202.90 in 2026; Social Security notifies exact amount (Medicare.gov PDF). If you have higher income, your premium is adjusted based on IRS data, and you’ll receive a notice from Social Security.

Annual deductible

The annual deductible for Medicare Part B in 2026 is $283, an increase of $26 from $257 in 2025 (CMS). This deductible resets each calendar year, running from January 1 through December 31. You must pay this deductible before Medicare begins covering 80% of your approved claims.

What this means: Part B is not a flat-rate benefit—your actual annual cost depends on how much healthcare you use. Someone who only sees their doctor once a year pays the premium plus the deductible plus 20% of that one visit. Someone managing multiple chronic conditions pays the premium, the deductible, and 20% of every covered service throughout the year.

Does Medicare Part B cover prescriptions?

Part B covers only a narrow slice of prescription drugs—primarily those administered in a clinical setting. Most retail prescriptions filled at a pharmacy require a separate Part D plan.

Limited outpatient drugs

Part B covers injectable drugs administered by a doctor during an office visit or outpatient procedure (Medicare.gov). This includes chemotherapy drugs, infusion therapies, and certain biologics. These drugs are covered under Part B because they are administered by a healthcare professional, not self-administered at home.

Part B covers a 3-month supply of covered insulin for no more than $35 per month, or $105 total (Medicare.gov). This applies specifically to insulin used with an insulin pump that is covered under Part B’s DME benefit. If you use syringe-delivered insulin or insulin pens without a covered pump, Part D handles the coverage instead.

Full prescriptions via Part D

For retail prescriptions you pick up at a pharmacy—pills, injections you administer yourself, specialty medications—you need Medicare Part D (Medicare.gov). Part D is optional prescription drug coverage sold by private insurance companies. Most Medicare beneficiaries have either a standalone Part D plan or a Medicare Advantage plan that includes drug coverage.

What this means for most seniors: Part B does not replace the need for Part D. If you take regular medications, budget for a Part D premium in addition to your Part B costs. Part D plans vary widely in cost, formulary (covered drug list), and pharmacy network, so comparing plans each year during open enrollment matters.

The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025.

Medicare Part B (Medical Insurance) helps cover 2 types of services: Medically necessary services and Preventive services.

For seniors reviewing their Medicare coverage, the picture is straightforward: Part B handles your outpatient care, preventive screenings, DME, and certain administered drugs, while leaving dental, vision, hearing aids, and most prescriptions to other coverage or out-of-pocket spending. The 2026 costs represent a meaningful increase from 2025, and budgeting for both the standard premium and the 20% coinsurance after deductible is essential for anyone relying on regular outpatient services.