What is covered by Medicare Part B?

Medicare Part B helps pay for doctors’ services, outpatient hospital care, medical supplies, and some other medical services that Medicare Part A does not cover, such as the services of physical, occupational, and speech therapists in an outpatient setting, and some home health care. Part B also covers outpatient mental health care.

Other services covered by Medicare Part B include, but are not limited to, the following:

•          Clinical laboratory services: blood tests, urinalysis, and more. Clinical Lab work is paid in full by Medicare.

•          Home health services: part-time skilled care, home health aide services

•          Durable medical equipment when supplied by a home health agency while getting Medicare-covered home health care, and other supplies and services

•          Outpatient hospital services: services for the diagnosis or treatment of an illness or injury

•          Blood: pints of blood needed as an outpatient or as part of a medical service covered by Medicare Part B, after the first 3 pints

•          Ambulance service: when other transportation would endanger your health. (For more information on coverage, payment, and rights and protection issues related to ambulance services, get a copy of Medicare Coverage of Ambulance Services, CMS Pub. No. 11021, by visiting www.medicare.gov on the web.)

•          Part B also covers some preventive services

 

Medicare Part B also covers preventive services like exams, lab tests, and screening shots to help prevent, find, or manage a medical problem. Preventive services may find health problems early when treatment works best. The Medicare & You handbook includes guidelines for who is covered and how often Medicare will pay for these services.

What Preventive services are covered?

Currently Medicare helps pay for:

•          “Welcome to Medicare” physical exam (one-time review of your health, as well as education and counseling about the preventive services you need. To be covered, you must have the physical exam within the first year you have Medicare Part B.)

•          Abdominal aortic aneurysm screening (new in 2007)

•          Bone mass measurement

•          Cardiovascular screenings

•          Colorectal cancer screenings

•          Diabetes screenings

•          Glaucoma tests

•          Screening mammograms

•          Pap test and pelvic exam (includes clinical breast examination)

•          Prostate cancer screening

•          Three kinds of vaccinations (shots)—for influenza, pneumococcal pneumonia, and Hepatitis B

•          Smoking cessation (counseling to stop smoking)

 

The Original Medicare Plan doesn’t cover everything. Items and services that aren’t covered include, but aren’t limited to:

•          Acupuncture

•          Dental care and dentures (with only a few exceptions)

•          Cosmetic surgery

•          Health care while traveling outside the U.S. (except in limited cases)

•          Hearing aids

•          Eye care (routine exam), eye refractions, and most eyeglasses

•          Long-term care, such as custodial care in a nursing home