What Does Medicare Part B Cover? Your Complete 2026 Guide

Medicare Part B covers medically necessary outpatient care, preventive services, doctor visits, durable medical equipment, and some home health care. 

It’s the part of Original Medicare that handles the care you receive outside a hospital bed. If you’re approaching 65 or helping a parent sort out their coverage, understanding exactly what Part B pays for and what it skips can save you from confusing bills and unexpected costs later.

This guide breaks down everything Part B covers, what falls outside its scope, how much it costs in 2026, and how it compares to Medicare’s other parts, so you walk away with a clear, complete picture.

Quick Answer:

Medicare Part B covers two broad categories of outpatient care: medically necessary services (doctor visits, outpatient procedures, lab tests, ambulance rides, mental health care, and durable medical equipment) and preventive services (annual wellness visits, screenings, and vaccines). In 2026, most enrollees pay a standard monthly premium of $202.90 and a $283 annual deductible before coverage kicks in at 80%.

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What Is Included in Medicare Part B?

Part B is built around the idea of covering care you get without being admitted to a hospital. That includes routine checkups, specialist visits, and the equipment or supplies your doctor says you need to manage a health condition.

Here’s what’s generally included:

• Doctor and specialist visits, including office consultations and second opinions
• Outpatient hospital care, such as care in an emergency room or same-day surgery center
• Durable medical equipment (DME), like wheelchairs, walkers, oxygen equipment, and hospital beds used at home
• Preventive services, including flu shots, mammograms, colorectal cancer screenings, and diabetes screenings
• Mental health services, covering outpatient therapy, psychiatric evaluations, and counseling
• Ambulance transportation when other transport could endanger your health
• Laboratory tests and diagnostic imaging, such as bloodwork, X-rays, and MRIs ordered by a doctor
• Limited outpatient prescription drugs, mainly ones administered in a clinical setting, like infusions or injections given by a provider
• Some home health care, such as part-time skilled nursing or physical therapy, when a doctor certifies it’s necessary.

Coverage generally kicks in once your deductible is met, and Medicare then pays 80% of the Medicare-approved amount, leaving you responsible for the remaining 20% (unless you have supplemental coverage).

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Which Items and Services Are Generally Covered Under Medicare Part B?

Category	Examples
Preventive care	Annual wellness visit, cancer screenings, bone density tests, vaccines
Medical equipment	Wheelchairs, walkers, CPAP machines, blood sugar monitors
Outpatient procedures	Same-day surgery, dialysis, chemotherapy administered in a clinic
Mental health	Outpatient therapy, depression screenings, substance use counseling
Diagnostics	Lab work, X-rays, CT scans, MRIs
Ambulance services	Emergency and, in limited cases, non-emergency transport
Second opinions	Before surgery, when medically necessary

If a service is ordered by a doctor as medically necessary and delivered outside an inpatient hospital stay, there’s a good chance Part B is the part of Medicare responsible for it.

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Which Two Services Are Covered Under Medicare Part B?

Two of the most commonly used Part B benefits are the annual wellness visit and durable medical equipment. The annual wellness visit lets you and your doctor build or update a personalized prevention plan at no extra cost once your deductible is met, while DME coverage helps pay for equipment like walkers or oxygen tanks that support daily living with a medical condition. Together, these two examples show how Part B blends preventive care with practical, everyday medical support.

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What Is Not Covered Under Medicare Part B?

Part B has clear limits, and knowing them upfront prevents billing surprises. Medicare Part B does not generally cover:

• Routine dental care, including cleanings, dentures, and most dental procedures
• Routine vision care, such as eye exams for glasses or contact lens fittings
• Hearing aids and related fitting exams
• Long-term custodial care, like help with bathing, dressing, or eating in a nursing home
• Most outpatient prescription drugs you’d pick up at a pharmacy (that’s typically Part D’s role)
• Cosmetic surgery, unless it’s needed to repair damage from an accident or improve a malformed body part
• Acupuncture, beyond limited coverage for specific chronic lower back pain treatment
• Care received outside the United States, with rare exceptions

This also answers related questions such as “What services are not covered by Medicare?”, “What services are not covered by Part B?”, and “Which type of care is not covered by Medicare?” In general, Part B does not cover custodial care, long-term care, or most routine dental, vision, and hearing services. Because of these gaps, many people purchase supplemental coverage to help pay for services that Part B does not cover.

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What Does Medicare Part B Cover for older people?

For most older people, Part B functions as the backbone of ongoing health management after 65. It covers the recurring things older adults rely on most: regular checkups with a primary care doctor, management of chronic conditions like diabetes or heart disease, physical therapy after an injury, and preventive screenings that catch problems early. It also covers durable equipment that supports independent living at home, such as walkers, hospital beds, and blood glucose monitors.

Because chronic disease management and mobility support are central to healthy aging, Part B often ends up covering a meaningful share of older people’s routine healthcare needs, even though it doesn’t cover everything.

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Does Medicare Part B Cover Prescriptions?

Medicare Part B covers a limited range of prescription drugs. These are medications administered by a healthcare provider. Examples include injectable chemotherapy drugs, certain infused medications, and some vaccines given in a clinical setting. However, it does not cover self-administered pills or prescriptions picked up at a retail pharmacy for everyday conditions such as high blood pressure or high cholesterol.

For broader prescription drug coverage, you’ll need a separate Part D plan or a Medicare Advantage plan that includes drug benefits. In short, Part B pays only for certain provider-administered medications. Routine take-home prescriptions are covered under Part D instead.

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Does Medicare Part B Cover Everything?

No. Part B is intentionally limited to medically necessary outpatient care and preventive services. It leaves out routine dental, vision, and hearing care, most take-home prescriptions, and long-term custodial care. Because of these gaps, many enrollees pair Part B with a Medicare Supplement (Medigap) policy, a Part D drug plan, or switch to a Medicare Advantage plan that bundles broader benefits.

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What Is Billed Under Medicare Part B?

Providers bill Part B for outpatient services rendered outside a hospital admission. Common billed items include office visit charges, outpatient procedure fees, lab and imaging costs, DME rental or purchase costs, and ambulance transport fees. Each claim is billed to Medicare using standardized procedure codes, and once your deductible is satisfied, Medicare typically pays 80% of the approved amount directly to the provider, while you’re billed for the remaining 20% coinsurance.

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How Much Does Medicare Part B Cost in 2026?

Medicare Part B costs most enrollees a standard monthly premium of $202.90 in 2026, along with an annual deductible of $283. After the deductible is met, you generally pay 20% coinsurance for most covered services, while Medicare pays the remaining 80%.

Higher-income beneficiaries pay more through the Income-Related Monthly Adjustment Amount (IRMAA). In 2026, IRMAA surcharges begin for individuals with a modified adjusted gross income above $109,000 (or $218,000 for joint filers), and total monthly premiums for the highest income bracket can reach roughly $689.90.

What is the lowest monthly premium for Medicare Part B? For most people, $202.90 is the floor that’s the standard premium everyone pays unless they qualify for state assistance programs like a Medicare Savings Program, which can help low-income beneficiaries cover part or all of the premium. There isn’t a lower standard tier; premiums only go up from there based on income, not down.

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Can I Avoid Medicare Part B Premium?

You generally cannot avoid the Part B premium if you’re enrolled and don’t qualify for assistance, since it’s a standard cost of participating in the program. However, there are legitimate ways to reduce or offset it:

• Medicare Savings Programs (MSPs), which can pay your Part B premium if your income and assets fall below state-specific limits
• Medicaid dual eligibility, where Medicaid covers the Part B premium for qualifying low-income individuals
• Employer or union coverage, which may reimburse part of your premium in some retiree benefit plans
• Delaying enrollment if you still have qualifying employer coverage through active work, avoiding the premium until you actually need Part B

Simply choosing not to enroll when you’re first eligible, without other qualifying coverage, usually leads to a late enrollment penalty added permanently to your premium, so skipping it isn’t typically a cost-saving move.

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Can I Get Medicare Part B for Free?

Medicare Part B is not free for most people. Unlike Part A, which many people receive premium-free based on their work history, Part B usually requires a monthly premium. However, you may qualify for a Medicare Savings Program or full Medicaid benefits. In that case, your state may pay your Part B premium on your behalf. As a result, Part B can be free to you personally, even though the program itself still charges a premium.

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What Is the Difference Between Medicare Part A and Part B?

Medicare Part A and Part B cover different settings of care. Part A is hospital insurance; it covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care following a hospital stay. Part B is medical insurance; it covers outpatient doctor visits, preventive care, durable medical equipment, and outpatient procedures.

Feature	Part A	Part B
Covers	Inpatient hospital, skilled nursing, hospice	Outpatient care, doctor visits, DME
2026 Premium	Often $0 if you have enough work history	$202.90 standard monthly
2026 Deductible	$1,736 per benefit period	$283 per year
Cost-sharing	Coinsurance by day for long stays	20% coinsurance after deductible

In short, Part A handles where you sleep and recover during serious medical events, while Part B handles the care you receive while living at home and managing everyday health needs.

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What Is the Difference Between Medicare Part D and Part B?

Part B and Part D cover different types of medications. Under Part B, Medicare covers drugs administered by a healthcare provider. These include infusions and injectable treatments given during an office visit. By contrast, Part D covers self-administered prescription drugs. Examples include pills, capsules, and take-home medications used to treat chronic conditions such as high blood pressure, diabetes, and high cholesterol.

Unlike Part B, which is part of Original Medicare, Part D is an optional prescription drug plan offered by private insurers. People who take regular prescription medications at home will likely need a Part D plan in addition to Part B. This is because Part B covers only a limited range of prescription drugs.

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What Part of Medicare Covers Prescriptions?

Medicare Part D is the part of Medicare that covers self-administered prescription drugs. It is offered by private insurers approved by Medicare. Each plan has its own formulary, premium, and cost-sharing structure. A formulary is the list of prescription drugs covered by the plan. Unlike Part B, which covers only a limited range of provider-administered medications, Part D helps pay for most everyday take-home prescriptions.

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What Does Medicare Part A Cover?

Medicare Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice care for people with a terminal diagnosis, and limited home health services. Most people do not pay a monthly premium for Part A. That’s because they or their spouse paid Medicare taxes for at least 10 years while working.

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What Does Medicare Part C Cover?

Medicare Part C, also known as Medicare Advantage, is an alternative way to receive your Medicare benefits through a private insurance company approved by Medicare. These plans must cover everything included in Original Medicare (Part A and Part B). Most plans also include extra benefits, such as dental, vision, hearing, and prescription drug coverage. However, costs, provider networks, and available benefits vary by plan and location.

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What Does Medicare Part D Cover?

Medicare Part D covers outpatient prescription drugs. These are medications you pick up at a pharmacy instead of receiving during a medical procedure. Each Part D plan has its own formulary, which lists the drugs it covers and their cost tiers. As a result, the medications covered and your out-of-pocket costs vary depending on the plan you choose.

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Difference Between Medicare Part A and B and C

Part A covers inpatient hospital and facility-based care. In contrast, Part B pays for outpatient medical care and preventive services. Meanwhile, Part C, also known as Medicare Advantage, is a bundled alternative offered by private insurers. It combines Part A and Part B coverage into a single plan and often includes Part D prescription drug coverage along with extra benefits.

In simple terms: A and B together make up Original Medicare, while C is a private-plan alternative that replaces both while adding extra features.

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What Is the Best Health Insurance for Older People?

There’s no single “best” option because the right choice depends on your health needs, budget, preferred doctors, and desired flexibility. Most people choose between two main paths:

• Original Medicare (Part A + Part B) with a Medigap policy and Part D plan. This option offers broad access to healthcare providers and more predictable costs. However, it usually comes with higher monthly premiums across multiple plans.
• Medicare Advantage (Part C). This option often bundles extra benefits and may have lower monthly premiums. However, it typically limits you to a provider network.

Compare plans based on your current health conditions, prescription medications, preferred doctors, and monthly budget. Also consider how much you’re comfortable paying in out-of-pocket costs. A licensed insurance advisor or your State Health Insurance Assistance Program (SHIP) can help you compare your options and choose the coverage that best fits your needs.

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Which of the Following Can Be Covered by Medicare Part B?

When comparing coverage options, a good rule of thumb is: if it’s medically necessary, ordered by a doctor, and delivered outside an inpatient hospital stay, it’s likely covered by Part B. This includes outpatient surgery, diagnostic tests, preventive screenings, mental health counseling, durable medical equipment, and ambulance services. Items like routine dental work, glasses, hearing aids, and long-term custodial care fall outside Part B, regardless of how they’re framed in a question or quiz.

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What Is the Medicare Part B Deductible?

The Medicare Part B deductible is the amount you pay out of pocket each year before Medicare starts sharing the cost of covered services. In 2026, the deductible is $283. After you pay that amount, Medicare typically covers 80% of the Medicare-approved cost for most covered services. You pay the remaining 20% unless you have supplemental coverage, such as a Medigap policy.

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How Much Will Medicare Part B Cost Me Per Month in 2026?

Most people will pay the standard $202.90 monthly premium in 2026. Your actual monthly cost depends on your income from two years prior (2024 tax returns): higher earners pay an added IRMAA surcharge, pushing the total monthly premium as high as roughly $689.90 for the highest income bracket. If you qualify for a Medicare Savings Program, your monthly cost could be reduced to $0.

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FAQs

Do I automatically get Medicare Part B when I turn 65?

If you’re already receiving Social Security or Railroad Retirement benefits, you’re usually enrolled automatically. If not, you’ll need to sign up yourself during your Initial Enrollment Period, which spans seven months around your 65th birthday.

What happens if I miss my Medicare Part B enrollment window?

You may face a late enrollment penalty, which permanently adds a percentage to your monthly premium for every 12 months you were eligible but didn’t enroll, unless you had qualifying employer coverage during that time.

Does Medicare Part B cover annual physical exams?

Part B covers a one-time “Welcome to Medicare” preventive visit in your first 12 months, and an annual wellness visit each year after, focused on preventive planning. It’s different from a traditional comprehensive physical, which may not be fully covered.

Can I have both Medicare Part B and a Medicare Advantage plan?

You need to be enrolled in both Part A and Part B before you can join a Medicare Advantage plan, since these plans work alongside your original Medicare eligibility rather than replacing your enrollment status.

Does Medicare Part B cover physical therapy?

Yes, Part B covers medically necessary outpatient physical therapy, occupational therapy, and speech-language pathology services, though cost limits and documentation requirements may apply for extended treatment.

How do I check if a specific service is covered under Part B?

You can review Medicare’s official coverage tool at Medicare.gov, ask your doctor’s billing office directly, or call 1-800-MEDICARE to confirm coverage for a specific procedure before receiving care.

Is Medicare Part B mandatory?

Part B isn’t legally mandatory, but declining it without other creditable coverage usually results in a lifelong late enrollment penalty and a gap in outpatient medical coverage, so most people choose to enroll when first eligible.

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Final Takeaway

Medicare Part B covers the outpatient backbone of your healthcare: doctor visits, preventive screenings, durable medical equipment, mental health services, and limited provider-administered drugs. 

It leaves out routine dental, vision, and hearing care, most take-home prescriptions, and long-term custodial care, which is why many people pair it with a Medigap policy or a Part D plan, or switch to Medicare Advantage. 

Knowing exactly where Part B’s coverage starts and stops helps you budget accurately and choose the right supplemental coverage for your situation.