Medicare Part B covers two types of services:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts Medicare (also referred to as assignment).
Other Part B covered services or items:
- Ambulance services
- Clinical research studies
- Durable medical equipment (DME)
- Getting a second opinion before surgery
- Outpatient prescription drugs
- Mental health care (outpatient)
Find out if Medicare covers your item, service or supply.
How much is covered?
Services | Benefit | Medicare pays in 2024 | You pay in 2024 |
|---|---|---|---|
Medical expenses
| Unlimited, if medically necessary | 80% of approved amount (after $240 deductible) | $240 deductible,* plus 20% of approved amount and limited charges above approved amount** |
Clinical laboratory tests | Unlimited, if medically necessary | Generally 100% of approved amount | Nothing for services |
Home Health Care | 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 | Unlimited, if medically necessary | Medicare payment to hospital based on hospital costs | 20% of billed amount* |
Blood | Unlimited during a benefit period if medically necessary | 80% of approved amount (after $240 deductible | For first three pints plus 20% of approved amount for additional pints*** |
* In 2024, after you pay the yearly deductible of $240, you typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy and durable medical equipment for the rest of the year.
** Federal law limits charges for physician services.
*** If the hospital gets blood from a blood bank at no charge, you won't pay for replacing it. If the hospital buys blood for you, you must either pay the hospital costs for the first three units of blood you get in a calendar year or have the blood donated by you or someone else.
Monthly Part B premium: In 2024, the standard premium is $174.70 (or higher depending on your income). However, a small number of people who get Social Security benefits will pay less due to the “hold harmless” provision. Social Security will tell you the exact amount you’ll pay. For more information, go to Part B costs.