Medicare Part B (medical insurance) covered services

Part B monthly premium:

  • $104.90
  • Based on income, some clients will pay: $146.90, $209.80, $272.70 or $335.70

Get a printable PDF of Medicare Part A and B covered services chart (PDF, 110KB)

Services Benefit Medicare pays You pay

Medical expenses

  • Doctor services
  • Inpatient and outpatient medical and surgical services, and supplies
  • Physical and speech therapy
  • Diagnostic tests
  • Durable medical equipment and other services
Unlimited, if medically necessary

80% of approved amount (after $147 deductible)

60% of approved amount for most outpatient mental health services

$147 deductible,* plus 20% of approved amount and limited charges above approved amount**

*After you pay $147 for covered services, the Part B deductible does not apply to any other covered services you receive for the rest of the year.

**Federal law limits charges for doctor services.

Clinical laboratory tests
Blood test, urinalysis and more

Unlimited, if medically necessary

Generally 100% of approved amount

Nothing for services

Home Health Care***
Part-time or intermittent skilled care, home health aide services, durable medical equipment and supplies, and other services  

***Part B pays for home health care only if you do not have Medicare Part A. If you have both Parts A and B, you'll have 100 visits under Part A and the remainder of the visits will be filed under Part B                                                                               

Unlimited, as long as you meet Medicare requirements

100% of approved amount

80% of approved amount for durable medical equipment

Nothing for services

20% of approved amount for durable medical equipment

Outpatient hospital treatment
Services for the diagnosis or treatment of an illness or injury

Unlimited, if medically necessary Medicare payment to hospital based on hospital costs

20% of billed amount (after $147 deductible)

Note: After you pay $147 for covered services, the Part B deductible does not apply to any other covered services you receive for the rest of the year.

Blood
When furnished by a hospital or skilled nursing facility during a covered stay

*If the provider gets blood from a blood bank at no charge, you won't pay for replacing it, but you will have a copayment for the blood processing and handling charge for each unit blood you receive. If the provider buys blood for you, you must either pay the provider costs for the first 3 units of blood you get in a calendar year or have the blood donated by you or someone else.

Unlimited during a benefit period if medically necessary 80% of approved amount (after $147 deductible  and starting with the fourth pint) For first three pints plus 20% of approved amount for additional pints*

Updated 07/30/2014

See also

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