Medicare Part B covers outpatient medical services, including doctor visits, preventive screenings, mental health care, durable medical equipment, and home health services. For 2025, the standard monthly premium is $185, with an annual deductible of $257. After you meet that deductible, you typically pay 20% of the Medicare-approved amount for most services.
Doctor Visits and Outpatient Care
Part B covers two broad categories: medically necessary services and preventive services. Medically necessary services include visits to doctors and specialists, outpatient surgeries, diagnostic tests, and lab work needed to diagnose or treat a medical condition. If your doctor orders it and it meets accepted standards of medical practice, Part B generally picks up the tab (minus your 20% coinsurance).
This extends to outpatient hospital services as well. If you need surgery, imaging, or other treatment that doesn’t require an overnight hospital stay, Part B is the part of Medicare that covers it. Keep in mind that if you receive care in a hospital outpatient department, you may owe an additional copayment to the hospital on top of your standard coinsurance.
Preventive Screenings and Vaccines
One of the most valuable features of Part B is its preventive care coverage, and most of these services cost you nothing if your provider accepts Medicare assignment. The list is extensive:
- Cancer screenings: mammograms, colonoscopies, lung cancer screenings with low-dose CT, prostate cancer screenings, and cervical/vaginal cancer screenings
- Heart and metabolic screenings: cardiovascular disease screenings, diabetes screenings, and abdominal aortic aneurysm screenings
- Infectious disease screenings: HIV, hepatitis B, hepatitis C, and sexually transmitted infections
- Mental health: one depression screening per year
- Other screenings: bone mass measurements, glaucoma tests, and alcohol misuse counseling
Part B also covers four types of vaccines at no cost: flu shots, pneumococcal shots, COVID-19 vaccines, and hepatitis B shots.
Two visits deserve special attention. The one-time “Welcome to Medicare” preventive visit is available within your first 12 months of enrollment and includes a review of your health risks, including depression. After that, you’re eligible for a yearly wellness visit, which is your chance to sit down with your doctor, update your health history, and create or revise a prevention plan. Neither of these is a head-to-toe physical exam (routine physicals are actually excluded from Medicare), but they’re useful for catching problems early.
Mental Health Services
Part B covers a wide range of outpatient mental health care. This includes individual and group psychotherapy, psychiatric evaluations, medication management, family counseling when it supports your treatment, and diagnostic testing. Partial hospitalization and intensive outpatient programs are also covered for people who need more structured support without a full inpatient stay. Services related to substance use disorder treatment fall under Part B as well.
You can see psychiatrists, clinical psychologists, clinical social workers, nurse practitioners, physician assistants, marriage and family therapists, and licensed mental health counselors. Part B also covers FDA-cleared digital mental health treatment devices and safety planning interventions if you’re at risk of suicide or overdose. After your deductible, you pay the standard 20% coinsurance for mental health visits.
Durable Medical Equipment
If your doctor prescribes medical equipment for use in your home, Part B covers it. The equipment must be durable (built to withstand repeated use), medically necessary, expected to last at least three years, and primarily useful for someone who is sick or injured. Covered items include wheelchairs and scooters, walkers, canes, crutches, hospital beds, oxygen equipment, CPAP machines for sleep apnea, glucose monitors with test strips and supplies, and infusion pumps.
You’ll pay 20% of the Medicare-approved amount for most equipment, and Medicare requires that you get it from a Medicare-approved supplier. For some items like wheelchairs or oxygen, Medicare may rent the equipment to you rather than purchasing it outright.
Home Health Services
Part B covers part-time home health care if you meet specific conditions. You must be considered “homebound,” meaning leaving your home either isn’t recommended due to your condition or requires considerable effort, such as needing a wheelchair, walker, or help from another person. A health care provider must assess you face-to-face and certify that you need skilled care, and a Medicare-certified home health agency must deliver it.
Covered home health services include skilled nursing care, physical therapy, occupational therapy, and speech-language pathology. In most cases, you can receive up to 8 hours of combined skilled nursing and home health aide services per day, with a maximum of 28 hours per week. For short-term needs, that cap can stretch to 35 hours per week.
What Part B won’t cover at home: 24-hour care, meal delivery, housekeeping unrelated to your care plan, or personal care like bathing and dressing when that’s the only type of help you need.
What Part B Does Not Cover
Several common health expenses fall outside Part B entirely. The gaps that catch most seniors off guard include:
- Dental care: routine cleanings, fillings, extractions, and dentures
- Vision: eye exams for prescription glasses and the glasses themselves
- Hearing: hearing aids and the exams required to fit them
- Long-term care: nursing home stays for custodial care
- Cosmetic surgery
- Routine physical exams (the yearly wellness visit is covered, but a traditional head-to-toe physical is not)
Many seniors fill these gaps with a Medicare Advantage plan (Part C), a Medigap supplemental policy, or standalone dental and vision insurance.
What You’ll Pay in 2025
The standard Part B premium for 2025 is $185 per month, deducted automatically from your Social Security check. Your annual deductible is $257, and after that, you pay 20% coinsurance for most covered services. Preventive services generally have no cost sharing at all.
If your income is higher, you’ll pay more. Medicare uses your tax return from two years prior to calculate an Income-Related Monthly Adjustment Amount (IRMAA). For individual filers earning more than $106,000 (or joint filers above $212,000), the monthly premium starts at $259 and can climb as high as $628.90 for the highest earners.
Late Enrollment Penalties
If you don’t sign up for Part B when you’re first eligible and you don’t have qualifying employer coverage, you’ll face a permanent penalty. Your premium increases by 10% for every full 12-month period you could have had Part B but didn’t. That surcharge applies for as long as you have Part B, which for most people means the rest of their life. If you delayed enrollment by three years, for example, your premium would be 30% higher than the standard amount every month going forward.