If you're new to Medicare or just trying to better understand your benefits, one of the most common questions is: What does Medicare Part B actually cover? You might hear terms like “outpatient care” or “medical insurance,” but what does that mean for you?
Let’s break it down into plain, everyday language—so you can make the most of your Medicare benefits in 2026.
Think of Medicare Part B as Your Everyday Medical Insurance
If you’ve ever had employer health coverage or bought insurance on your own, Medicare Part B will feel familiar. This is the part of Medicare that helps cover your routine medical care, including doctor visits, outpatient treatments, preventive care, and durable medical equipment.
Instead of paying premiums to a private insurer like Blue Cross, Aetna, or UnitedHealthcare, with Part B, you’re now paying the federal government for that same kind of medical insurance.
What Does Medicare Part B Cover?
Medicare Part B covers two broad types of services:
1. Medically Necessary Services
These are services or supplies needed to diagnose or treat a medical condition. Part B covers:
- Doctor visits (primary care and specialists)
- Outpatient care (anything where you’re not admitted to a hospital)
- Lab tests and blood work
- X-rays and diagnostic imaging
- Physical and occupational therapy
- Mental health care (therapy, counseling, and psychiatric visits)
- Ambulance services
- Durable Medical Equipment (DME) like:
- Wheelchairs
- Walkers
- Oxygen equipment
- CPAP machines
It also includes cancer treatments like chemotherapy and radiation when provided on an outpatient basis. Learn more about what Part B covers (Medicare.gov).
2. Preventive Services
These services help you stay healthy and catch issues early. They include:
- Annual wellness visit
- Flu and COVID-19 shots
- Cancer screenings (mammograms, colonoscopies, prostate screenings)
- Cardiovascular screenings
- Diabetes screenings and self-management training
- Bone density tests
The good news? Most preventive services are fully covered, meaning you pay nothing out of pocket as long as your provider accepts Medicare. Here is a full list of preventative and screening services covered by Medicare Part B: Preventative Screening Services (Medicare.gov).
What’s Not Covered by Part B?
Part B does not cover everything. It won’t pay for:
- Prescription drugs you take at home (covered under Part D)
- Dental care
- Eye exams or glasses
- Hearing aids
- Long-term care (help with dressing, bathing, etc.)
- Hospital stays (that’s covered under Part A)
For these services, you’ll need to look into Medicare Advantage plans or add supplemental coverage.
How Much Does Part B Cost in 2026?
As of 2026, the standard monthly premium for Medicare Part B is $202.90 per person.
There’s also an annual deductible, which is $283 in 2026. Once you meet the deductible, you’ll typically pay 20% of the Medicare-approved amount for most services.
Keep in mind: If you have a Medicare Advantage plan, your costs may be different. Some plans have $0 deductibles or set co-pays, so it’s important to check your specific plan details.
How Do You Enroll in Part B?
Most people get Part B automatically when they turn 65 if they’re already receiving Social Security. If not, you’ll need to sign up during your Initial Enrollment Period or during a Special Enrollment Period if you delayed it due to employer coverage.
Call to Action
Understanding Medicare Part B helps you make smart decisions about your health and your wallet. Still have questions about how Part B works with the rest of your coverage? Want to explore Medicare Advantage or Supplemental Plans?
Join a Medicare class on GetSetUp and get your questions answered by experts in easy-to-follow sessions.