Medicare Part B Covered Services
If you’re in a Medicare Advantage Plan (like an HMO or PPO) or have other insurance, your costs may be different. Contact your plan or benefits administrator directly to find out about the costs. Under Original Medicare, if the Part B deductible ($166 in 2016) applies, you must pay all costs (up to the Medicare-approved amount) until you meet the yearly Part B deductible before Medicare begins to pay its share. Then, after your deductible is met, you typically pay 20% of the Medicare-approved amount of the service, if the doctor or other health care provider accepts assignment. There’s no yearly limit for what you
You pay nothing for most covered preventive services if you get the services from a doctor or other qualified health care provider who accepts assignment. However, for some preventive services, you may have to pay a deductible, coinsurance, or both. These costs may also apply if you get a preventive service in the same visit as a non-preventive service.
Medicare covers a one-time screening abdominal aortic aneurysm ultrasound for people at risk. You must get a referral from your doctor or other practitioner. You pay nothing for the screening if the doctor or other qualified health care provider accepts assignment .
Medicare covers voluntary Advance Care Planning as part of the Yearly “Wellness” visit. This is planning for care you would want to get if you become unable to speak for yourself.
Medicare covers one alcohol misuse screening per year for adults with Medicare (including pregnant women) who use alcohol, but don’t meet the medical criteria for alcohol dependency.
Medicare covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital , or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health.
Medicare covers the facility service fees related to approved surgical procedures provided in an ambulatory surgical center (facility where surgical procedures are performed, and the patient is expected to be released within 24 hours).
If the provider gets blood from a blood bank at no charge, you won’t have to pay for it or replace it. However, you’ll pay a copayment for the blood processing and handling services for each unit of blood you get, and the Part B deductible applies.
This test helps to see if you’re at risk for broken bones. It’s covered once every 24 months (more often if medically necessary ) for people who have certain medical conditions or meet certain criteria.
Medicare will cover one visit per year with a primary care doctor in a primary care setting (like a doctor’s office) to help lower your risk for cardiovascular disease.
Medicare Covered Services
Abdominal aortic aneurysm screening
Medicare covers a one-time screening abdominal aortic aneurysm ultrasound for people at risk. You must get a referral
Advance Care Planning
Medicare covers voluntary Advance Care Planning as part of the Yearly “Wellness” visit. This is planning for care you
Alcohol misuse screening and counseling
Medicare covers one alcohol misuse screening per year for adults with Medicare (including pregnant women) who use
Medicare covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital
Ambulatory surgical centers
Medicare covers the facility service fees related to approved surgical procedures provided in an ambulatory surgical
If the provider gets blood from a blood bank at no charge, you won’t have to pay for it or replace it. However, you’ll
Bone mass measurement (bone density)
This test helps to see if you’re at risk for broken bones. It’s covered once every 24 months (more often if medically
Breast cancer screening ( mammograms)
Medicare covers screening mammograms to check for breast cancer once every 12 months for all women with Medicare who
Medicare covers comprehensive programs that include exercise, education, and counseling for patients who meet at least
Cardiovascular disease (behavioral
Medicare will cover one visit per year with a primary care doctor in a primary care setting (like a doctor’s office) to
Cardiovascular disease screenings
These screenings include blood tests that help detect conditions that may lead to a heart attack or stroke.
Cervical and vaginal cancer screenings
Part B covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam,
Medicare covers chemotherapy in a doctor’s office, freestanding clinic, or hospital outpatient setting for people with
Chiropractic services (limited coverage)
Medicare covers manipulation of the spine if medically necessary to correct a subluxation (when one or more of the
Chronic Care Management Services
If you have 2 or more chronic conditions that are expected to last at least a year, Medicare may pay for a health care
Clinical research studies
Clinical research studies test how well different types of medical care work and if they’re safe. Medicare covers some
Colorectal cancer screenings
Medicare covers these screenings to help find precancerous growths or find cancer early, when treatment is most
Continuous Positive Airway Pressure
Medicare covers a 3-month trial of CPAP therapy if you’ve been diagnosed with obstructive sleep apnea. Medicare may
Defibrillator (implantable automatic)
Medicare covers these devices for some people diagnosed with heart failure. If the surgery takes place in an outpatient
Medicare covers one depression screening per year. The screening must be done in a primary care setting (like a
Medicare covers these screenings if your doctor determines you’re at risk for diabetes. You may be eligible for up to 2
Diabetes self‑management training
Medicare covers diabetes outpatient self-management training to teach you to cope with and manage your diabetes.
Medicare covers blood sugar testing monitors, blood sugar test strips, lancet devices and lancets, blood sugar control
Doctor and other health care provider
Medicare covers medically necessary doctor services (including outpatient services and some doctor services you get
Durable medical equipment (DME)
Medicare covers items like oxygen equipment and supplies, wheelchairs, walkers, and hospital beds ordered by a doctor
EKG or ECG (electrocardiogram) screening
Medicare covers a one-time screening EKG/ECG if referred by your doctor or other health care provider as part of your
Emergency department services
These services are covered when you have an injury, a sudden illness, or an illness that quickly gets much worse.
Medicare covers one pair of eyeglasses with standard frames (or one set of contact lenses) after cataract surgery that