Understanding Medicare Part B costs and coverage 

 

What Medicare Part B covers:  

• Doctor visits 
• Urgent care 
• Outpatient care 
• Home health care 
• Durable medical equipment 
• Many other preventive services 
   

How are my needs covered by Part B?  

For most non-preventive under Part B, you’ll have to meet your yearly deductible. In 2026, the Part B deductible is $283. Once you meet your deductible, Original Medicare will generally pay 80% of the Medicare-approved amount. You’ll pay the remaining 20% out of pocket.   

You do need to pay a premium for Part B coverage. In 2026, the Medicare Part B premium is $202.90 per month or higher, depending on your income. 

Before you visit a doctor, schedule a surgery, or buy supplies, it’s important to ask if providers take Original Medicare (Parts A and B). If they don’t, they may charge more. 
 

What’s covered for doctor, specialist, and urgent care visits by Part B:

Part B covers visits to your primary care doctor and/or specialists, if they accept Medicare. Specialists are doctors who focus on a specific type of care, like allergists, cardiologists, endocrinologists, and dermatologists.  

You’ll also be covered for visits to urgent care if you need treatment for a sudden illness or injury that isn’t a medical emergency. After you meet your Part B deductible, you’ll pay 20% of the Medicare-approved amount. Please note that other costs may apply.

Details on coverage and costs for durable medical supplies, equipment, and prosthetics Part B will cover medically necessary supplies, equipment, and prosthetic devices. It may also cover artificial eyes and limbs, if they are prescribed by your doctor and the supplier of the device is enrolled in Medicare. Medicare-approved suppliers must meet Medicare quality standards and meet Medicare payment requirements.

Some of the most common medical supplies and equipment include: 

• Wheelchairs 
• Scooters 
• Canes and walkers 
• Oxygen equipment and accessories 
• Diabetic monitoring supplies 
• Therapeutic shoes and inserts 
• Slings and brace 
• CPAP devices 
• Hospital beds and lifts 
• Prosthetic devices, artificial eyes, and limbs 
   

What’s covered for outpatient physical, occupational, and speech therapy by Part B:

Part B will cover medically necessary therapy. Outpatient therapy Is provided without being admitted as an inpatient (e.g., clinic, doctor’s office, or hospital outpatient department). Therapy received in an inpatient setting is generally covered by Original Medicare Part A. Types of therapy included are: 

• Physical 
• Occupational 
• Speech 
• Pulmonary rehabilitation programs (for certain conditions, when medically necessary and ordered by a doctor)

You might think of therapy as helping you get back the use of a certain function after injury or illness. In some cases, therapy may also be a preventive measure to help maintain your condition or prevent it from getting worse.
 

What’s covered for emergency ambulance transportation by Part B:

If you need medically necessary services and traveling via another vehicle could endanger your health, Part B will cover ground ambulance transportation to the nearest hospital, critical access hospital, or skilled nursing facility able to give the care you need.   

If you need urgent help, Original Medicare may cover emergency transportation in an airplane or helicopter.  

Original Medicare may cover non-emergency, but medically necessary, ambulance transportation if you have an order from your doctor.