Coverage Part B will cover visits to your primary care or family doctor and specialists as long as they accept patients covered by Medicare. A specialist is a doctor who focuses on care for a particular system, function, or condition. Some common specialists include allergists, cardiologists, dermatologists and endocrinologists. You will also be covered for visits to covered urgent care facilities if you need treatment for a sudden illness or injury that isn’t a medical emergency.

https://www.medicare.gov/coverage/doctor-other-health-care-provider-services https://www.medicare.gov/coverage/urgently-needed-care

Coverage Part B will cover a large variety of supplies, equipment, prosthetic devices, and artificial eyes and limbs as long as they are prescribed by your doctor and the supplier of the device is enrolled in Medicare. Suppliers must meet a strict quality standard and offer competitive pricing of the equipment they provide. 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 braces, CPAP devices, and hospital beds and lifts. Medicare will also cover prosthetic devices and artificial eyes and limbs. The full list of covered devices is extensive and based on the type of care required.

https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage https://www.medicare.gov/coverage/prosthetic-devices https://www.medicare.gov/coverage/artificial-eyes-limbs

Coverage Part B will cover medically necessary therapy. Outpatient therapy is provided outside a hospital or skilled nursing facility. Therapy received in an in-patient setting is generally covered by Original Medicare Part A. Physical, occupational, and speech therapy are all covered. Cardiac and pulmonary rehabilitation services are also covered. Most people think of therapy to regain the use of a particular function after an injury or illness, but in some instances, it can also be used in a preventative measure to manage the progression of a chronic condition.

https://www.medicare.gov/coverage/speech-language-pathology-services https://www.medicare.gov/coverage/occupational-therapy https://www.medicare.gov/coverage/physical-therapy https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs https://www.medicare.gov/coverage/cardiac-rehabilitation-programs

Coverage 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 that’s able to administer the care you need. If you need immediate assistance, Original Medicare may cover emergency transportation in an airplane or helicopter. Additionally, Original Medicare may cover non-emergency but medically necessary ambulance transportation if you have a written order from your doctor.

https://www.medicare.gov/coverage/ambulance-services

For nearly everything covered under Part B, you’ll first be responsible for meeting your yearly deductible. The yearly Part B deductible for 2021 is $203. Once you meet your deductible, Original Medicare will typically pay 80% of the Medicare-approved amount, and you’ll be responsible for paying the remaining 20% out of pocket. If your doctor or supplier does not accept Original Medicare, you may have to pay more than that. Before you have a doctor visit, schedule a procedure, or purchase supplies, it’s important to ask your doctors and suppliers if they participate in Original Medicare.

https://www.medicare.gov/your-medicare-costs/part-b-costs

Coverage Original Medicare covers clinical diagnostic laboratory services deemed medically necessary including certain blood tests, urinalysis, tests on tissue specimens, and certain screenings. Your doctor or practitioner must order them, and they must be administered in a Medicare-approved laboratory.

https://www.medicare.gov/coverage/clinical-laboratory-tests

Coverage Original Medicare covers dozens of preventive screenings and services including diabetes screenings, depression screenings, mammograms, colonoscopies, glaucoma tests, and various cancer screenings. For a full list of covered preventive screenings and programs, check Medicare.gov.

https://www.medicare.gov/coverage/preventive-screening-services

Coverage Once you’ve had Original Medicare Part B coverage for over 12 months, Original Medicare covers an annual “wellness” visit, so you can receive care and advice based on your current mental and physical health. You’ll fill out a Health Risk Assessment questionnaire and your doctor will help you create, update, and maintain a personalized prevention plan and routine screening schedule to help you stay healthy.

https://www.medicare.gov/coverage/yearly-wellness-visits

Part B typically covers the costs of preventive care and procedures at 100%, so you will usually have no out-of-pocket expenses.

Coverage With few exceptions Original Medicare Parts A and B do not cover prescription drug costs. Medicare prescription drug coverage is an optional benefit offered to everyone who has Original Medicare. Medicare participants must obtain prescription drug coverage as soon as they’re eligible for Medicare, unless they have creditable prescription coverage somewhere else, such as a spouse’s employer-sponsored health coverage. If you enroll later, you may be subject to a late penalty. There are two options for prescription drug coverage, also known as Part D. Stand-alone Part D prescription drug plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans. Or Medicare Advantage Prescription Drug plans, also known as Part C. These plans combine all the benefits of Part A and Part B coverage, and include prescription drug coverage (Part D). Without this additional coverage you could be responsible for paying 100% of the cost of your medications.

https://www.medicare.gov/drug-coverage-part-d

Coverage Original Medicare does not cover most dental care. Medicare participants can obtain separate dental coverage from a private insurance company such as Humana. There are two options for dental coverage. Stand-alone dental insurance plans or Medicare Advantage plans also known as Part C. Many Medicare Advantage plans include coverage for routine dental care such as cleanings, exams, and X-rays. You may also choose to purchase an optional supplemental benefit which will add coverage for common dental procedures. If you choose not to purchase a dental plan you could be responsible for paying 100% of the cost of your dental care.

https://www.medicare.gov/coverage/dental-services https://www.medicaid.gov/medicaid/benefits/dental/index.html

Coverage Part B covers a simple vision test as part of the “Welcome to Medicare” preventive visit, but it’s only offered once during your first year of Part B coverage. Part B also covers a yearly eye exam for those living with diabetes and diabetic retinopathy, as long as it’s performed by an eye doctor who is legally permitted to do testing in the state where you live. Eye exams for diagnostic purposes, such as testing for glaucoma or macular degeneration, may also be covered. If treatment may improve a chronic eye condition, like glaucoma or cataracts, and is viewed as medically necessary by a physician participating in Medicare, Original Medicare may cover it. You’ll need to check with your doctor to see if your condition is deemed medically necessary. However, Original Medicare Parts A and B do not cover most routine vision care like routine eye-exams, eyeglasses, contacts, and corrective procedures. Original Medicare participants can obtain separate vision coverage from a private insurance company such as Humana. There are two options for vision coverage. Stand-alone vision insurance plans or Medicare Advantage plans also known as Part C. Many Medicare Advantage plans include coverage for routine vision care. You may also choose to purchase an optional supplemental benefit if you need additional coverage. If you choose not to purchase a vision plan you could be responsible for paying 100% of the cost of your vision care.

https://www.medicare.gov/coverage/eye-exams-for-diabetes https://www.medicare.gov/coverage/eye-exams https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit

Coverage Part B covers diagnostic hearing and balance exams if ordered to determine if medical treatment is needed. However, Original Medicare does not cover hearing exams, hearing aids or fittings. Medicare participants can obtain separate hearing coverage from a private insurance company such as Humana. Many Medicare Advantage plans, also known as Part C, include coverage for routine hearing care. If you choose not to purchase hearing coverage you could be responsible for paying 100% of the cost of your hearing care.

https://www.medicare.gov/coverage/hearing-balance-exams

Coverage Original Medicare covers certain in-home health services, including skilled nursing care, physical therapy, speech pathology, and occupational therapy. Original Medicare will not pay for 24-hour in-home care or meals delivered to you at home. If your in-home care needs exceed what can be classified as part-time or intermittent skilled nursing care, they will not be eligible for coverage. If you choose to purchase a Humana Medicare Advantage plan you may have access to additional home health programs at no additional cost. Our care managers offer support to eligible members—in home or by phone—that fits your schedule. This may mean helping coordinate exams and screenings, answering care-related questions, discussing health changes, and helping you live more independently at home. Some plans even include meal delivery after an in-patient hospital stay.

https://www.medicare.gov/coverage/home-health-services

In most cases you could be responsible for paying 100% of the cost of your prescriptions, dental, vision, hearing, and at-home care. If you choose not to purchase additional coverage for these items from a private insurance company such as Humana.

This is not a full summary of Original Medicare coverage, benefits, and costs. For a full list of covered services use the "Is my test, item or service covered?" search tool on Medicare.gov

https://www.medicare.gov/coverage