Medicare Part B covers a broad range of outpatient medical services, preventive care, doctor visits, and medically necessary equipment for eligible Americans in 2026. As of February 21, 2026, Part B continues to function as the medical insurance portion of Original Medicare, helping millions of seniors and qualified individuals with disabilities manage everyday healthcare costs.
Understanding what is included under Medicare Part B is essential for budgeting, planning appointments, and avoiding unexpected medical bills. Below is a detailed, up-to-date explanation of what Medicare Part B includes this year and how the coverage works.
What Is Medicare Part B?
Medicare Part B is one half of Original Medicare.
- Part A generally covers inpatient hospital stays.
- Part B covers outpatient medical services and physician care.
Most Americans become eligible at age 65. Younger individuals with qualifying disabilities, end-stage renal disease, or ALS may also enroll.
Unlike Part A, which many people receive premium-free based on work history, Part B requires a monthly premium. Beneficiaries also pay an annual deductible and typically 20 percent coinsurance for covered services.
Doctor Visits and Medical Appointments
One of the most important areas Medicare Part B covers is physician services.
This includes:
- Primary care visits
- Specialist consultations
- Follow-up appointments
- Second surgical opinions
- Chronic condition management
When a provider accepts Medicare assignment, Part B generally pays 80 percent of the approved amount after the annual deductible is met. The patient is responsible for the remaining 20 percent unless they have supplemental coverage.
Routine office visits remain one of the most frequently used benefits under Part B.
Outpatient Hospital Services
Part B also pays for care received in a hospital without formal admission.
Examples include:
- Emergency room visits when not admitted
- Same-day surgical procedures
- Observation services
- Outpatient diagnostic testing
If a patient is admitted as an inpatient, Part A applies instead.
Understanding the difference between inpatient and outpatient status can affect cost-sharing responsibilities.
Preventive Services in 2026
Preventive care remains a key focus of Medicare.
Medicare Part B covers numerous preventive services at no cost to the beneficiary when providers accept Medicare assignment.
Covered preventive benefits include:
- Annual wellness visits
- Cardiovascular screenings
- Diabetes screenings
- Depression screenings
- Alcohol misuse screenings
- Obesity counseling
- Tobacco cessation counseling
Vaccines covered under Part B include:
- Influenza (flu) shots
- Pneumococcal vaccines
- Hepatitis B shots for high-risk individuals
- COVID-19 vaccines
Cancer screenings covered under Part B include:
- Mammograms
- Colorectal cancer screenings
- Prostate cancer screenings
- Cervical cancer screenings
Preventive services play a major role in early detection and disease management.
Mental Health and Behavioral Health Coverage
Mental health coverage has grown in importance under Medicare.
Medicare Part B covers outpatient mental health services such as:
- Individual psychotherapy
- Group therapy sessions
- Psychiatric diagnostic evaluations
- Medication management
- Substance use disorder treatment
In recent years, access to licensed clinical social workers and certain mental health professionals expanded under Medicare rules.
Telehealth mental health visits remain covered when eligibility requirements are met.
Coinsurance generally applies after the deductible, unless supplemental insurance reduces out-of-pocket costs.
Durable Medical Equipment (DME)
Another critical area Medicare Part B covers is durable medical equipment prescribed for home use.
Examples include:
- Wheelchairs and scooters
- Walkers and canes
- Hospital beds
- Oxygen equipment
- CPAP machines for sleep apnea
- Blood sugar monitors
The equipment must be medically necessary and ordered by a Medicare-enrolled provider.
Patients usually pay 20 percent of the Medicare-approved amount after meeting the deductible.
Suppliers must participate in Medicare for coverage to apply.
Diagnostic Tests and Imaging
Diagnostic testing helps physicians identify and monitor medical conditions.
Part B covers:
- Blood tests
- Urinalysis
- Pathology services
- X-rays
- CT scans
- MRI scans
- Ultrasounds
- EKGs
Lab tests are often covered at no cost if providers accept Medicare assignment.
Advanced imaging typically requires coinsurance payments.
Outpatient Surgery and Procedures
Many surgical procedures no longer require overnight hospital stays.
Medicare Part B covers outpatient surgeries performed in:
- Hospital outpatient departments
- Ambulatory surgical centers
Common procedures include:
- Cataract surgery
- Arthroscopic joint procedures
- Minor orthopedic surgeries
- Skin lesion removals
Patients pay coinsurance after the deductible.
Anesthesia and related physician services are also covered.
Emergency and Ambulance Services
Emergency department visits fall under Part B when the patient is not admitted as an inpatient.
Part B also covers ambulance transportation when:
- Other transportation could endanger the patient’s health
- The transport is medically necessary
Air ambulance services may be covered in qualifying situations.
Cost-sharing rules apply based on Medicare-approved amounts.
Home Health Services
Medicare Part B covers certain home health services when ordered by a physician.
Covered services may include:
- Skilled nursing care (part-time)
- Physical therapy
- Occupational therapy
- Speech-language therapy
To qualify, the patient must meet Medicare’s home health eligibility criteria.
Home health care must be medically necessary and provided by a Medicare-certified agency.
Telehealth Services in 2026
Telehealth continues to play a role in outpatient care.
Medicare Part B covers approved telehealth services for eligible beneficiaries.
Services may include:
- Routine checkups
- Mental health appointments
- Specialist consultations
- Chronic care management
Coverage depends on current federal rules governing telehealth access.
Patients may receive care from home if eligibility requirements are satisfied.
What Medicare Part B Does Not Cover
While coverage is extensive, certain services are excluded.
Part B generally does not cover:
- Routine dental care
- Dentures
- Routine vision exams for glasses
- Hearing aids
- Cosmetic surgery
- Long-term custodial nursing home care
Some limited exceptions apply, such as medically necessary eye procedures.
Beneficiaries often purchase Medigap policies or enroll in Medicare Advantage plans for additional benefits.
Costs in 2026
Medicare Part B requires:
- A monthly premium
- An annual deductible
- 20 percent coinsurance for most services
Higher-income beneficiaries pay Income-Related Monthly Adjustment Amounts.
Premiums and deductibles are updated annually under federal guidelines.
Planning for cost-sharing helps avoid surprises.
How Part B Works with Other Insurance
Many beneficiaries combine Part B with supplemental coverage.
Options include:
- Medigap policies to reduce coinsurance
- Employer-sponsored retiree coverage
- Medicare Advantage plans
Medicare Advantage plans must provide at least the same coverage as Original Medicare Part B, though they may offer additional benefits.
Understanding coordination of benefits helps minimize out-of-pocket costs.
Eligibility and Enrollment
Individuals typically enroll in Part B:
- At age 65 during their initial enrollment period
- During a special enrollment period if covered by employer insurance
- During the general enrollment period if they missed earlier opportunities
Late enrollment can result in permanent premium penalties.
Reviewing enrollment timelines ensures continuous coverage.
Coverage Overview at a Glance
| Category | Covered Under Part B? |
|---|---|
| Doctor visits | Yes |
| Preventive screenings | Yes |
| Outpatient surgery | Yes |
| Mental health therapy | Yes |
| Durable medical equipment | Yes |
| Routine dental | No |
| Long-term nursing home care | No |
This table reflects current Medicare policy as of February 2026.
Why Staying Informed Matters
Healthcare decisions affect both health outcomes and financial stability.
Understanding what Medicare Part B covers allows beneficiaries to:
- Schedule preventive screenings
- Access necessary equipment
- Plan for coinsurance costs
- Avoid uncovered services
Federal guidelines may change over time, so staying updated remains important.
The Bottom Line
Medicare Part B covers doctor visits, outpatient services, preventive screenings, mental health treatment, durable medical equipment, diagnostic testing, telehealth services, and many medically necessary procedures in 2026. It does not cover routine dental, most vision care, hearing aids, or long-term custodial care.
Knowing exactly what is included empowers beneficiaries to make informed healthcare choices under current federal rules.
Do you have experience navigating Medicare Part B benefits? Share your insights and stay informed about coverage updates that could affect your care.