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What Is Medicare Part B?

Medicare Part B is your outpatient medical coverage. It’s part of Original Medicare and works alongside Part A, which covers hospital stays.

When you enroll, you’ll pay a monthly premium and a yearly deductible. After meeting that deductible, Medicare typically covers 80% of approved medical costs, while you’re responsible for the remaining 20%.

As an agent, I explain it simply: Part A is inpatient coverage, for when you’re hospitalized. Part B is outpatient coverage, for care you receive outside the hospital.

What Does Medicare Part B Cover?

Doctor Visits and Outpatient Care

Medicare Part B covers medically necessary doctor visits, specialist appointments, lab tests, X-rays, outpatient surgeries, and most emergency room services.

Seeing a doctor who accepts Medicare assignment means you’ll only pay your deductible and coinsurance.

If your ER visit results in a hospital admission, your stay moves under Medicare Part A instead of Part B.
But if you’re kept for observation only, it still counts as outpatient care and remains covered under Part B.

Common examples:

• Primary care visits
• Specialist consultations
• Outpatient physical or occupational therapy
• Mental health visits
• Medical imaging or lab work

Preventive Services

Part B also includes preventive care designed to catch health problems early. Most of these services are free, as long as your doctor accepts Medicare assignment.

Examples include:

• Annual “Welcome to Medicare” visit and yearly wellness visits
• Flu and COVID-19 vaccines
• Screenings for cancer, diabetes, or heart disease
• Depression and alcohol misuse screenings

If your provider performs additional tests or services that are not part of the preventive visit, you may pay coinsurance and your Part B deductible for those extra items.

You can see the full list of preventive services at Medicare.gov Preventive Services.

Durable Medical Equipment (DME)

If your doctor orders equipment for use at home, such as oxygen, walkers, or CPAP machines, Part B covers 80% of the cost. You pay the remaining 20% after meeting your deductible.

What Medicare Part B Doesn’t Cover

Part B does not cover everything. The most common uncovered items include:

• Routine dental, vision, or hearing exams
• Prescription drugs (unless given during an outpatient procedure)
• Cosmetic procedures
• Long-term or custodial care
• Care received outside the U.S. (in most cases)

These gaps are where Medicare Supplement or Advantage plans can help.

If you’re comparing your options, read Medicare 101: What to Know Before Choosing a Plan for guidance.

Costs You Should Expect with Part B

Every year, Medicare updates the Part B premium and deductible amounts.
You’ll pay a monthly premium and a small yearly deductible before Medicare begins covering services.
After that, Medicare generally pays 80% of approved costs, and you’re responsible for the remaining 20%.

If your income is above a certain level, you may pay an additional monthly amount known as an Income-Related Monthly Adjustment Amount (IRMAA).

You can check the current year’s premium and deductible details directly on SSA.gov or Medicare.gov for the most accurate information.

For help reviewing your total Medicare costs, read 3 Medicare Costs You Need to Double-Check Before AEP Ends.

When to Enroll in Part B

If you’re new to Medicare, you have a seven-month Initial Enrollment Period (IEP) to sign up for Part B.
That window includes:

• 3 months before your 65th birthday
• Your birthday month
• 3 months after your 65th birthday

Enrolling early—during those first three months—helps make sure your coverage starts on time.
If you wait until the last three months, your coverage could start later and leave a short gap.

If you delay because you still have employer coverage, you’ll have a Special Enrollment Period once that coverage ends, giving you up to eight months to enroll without penalty.

You can apply through SSA.gov Apply for Medicare.

How to Get Help Understanding Your Coverage

If you’re still unsure how Part B works or what’s included, start with my free Medicare Starter Kit.
It includes a printable checklist, a breakdown of each Medicare part, and simple steps to help you better understand your coverage and how it works.

Key Takeaways

• Medicare Part B covers outpatient, preventive, and durable medical services.
• You pay a monthly premium, deductible, and 20% coinsurance.
• It doesn’t cover dental, vision, or hearing.
• Knowing what’s included helps you plan and avoid surprise costs.

Resources and References

• Medicare.gov – Part B Coverage Overview
• SSA.gov – Medicare Premiums

Disclaimer

This content is for educational purposes only and does not constitute official Medicare advice. I am not affiliated with Medicare or any government agency. For complete coverage options, visit Medicare.gov or call 1-800-MEDICARE.

Examples shared are general scenarios for educational purposes and do not reflect any specific individual or situation. This content does not provide plan recommendations or enrollment guidance.