What does Medicare Part B not cover?

Medicare Part B doesn't cover routine dental, vision (eyeglasses/contacts), and hearing care (aids/exams), long-term care, most cosmetic surgery, or routine foot care, but it does cover medically necessary services, certain preventive care, DME, and limited outpatient drugs, with costs shared via deductibles and coinsurance. People often need separate vision/dental plans or a Medicare Advantage plan for these excluded services.

What is not covered on Medicare Part B?

Medicare Part B doesn't cover routine dental, vision (eyeglasses/contacts), and hearing care (aids/exams), long-term care, most cosmetic surgery, or routine foot care, but it does cover medically necessary services, certain preventive care, DME, and limited outpatient drugs, with costs shared via deductibles and coinsurance. People often need separate vision/dental plans or a Medicare Advantage plan for these excluded services.
 

What does Medicare Part B actually pay for?

Medicare Part B covers medically necessary outpatient services, doctor visits, preventive care (like flu shots, screenings), durable medical equipment (wheelchairs, walkers), ambulance services, lab tests (X-rays, bloodwork), mental health care, and some home health care, acting as essential medical insurance for services not covered by Part A. It helps pay for things like outpatient therapy, certain drugs administered in a doctor's office, and annual wellness visits, but typically excludes routine dental, vision, and hearing care, notes the {!nav}AARP as reported by the {!nav}}New York Times. 

Does part B pay for doctor visits?

Yes, Medicare Part B (Medical Insurance) , helps covers doctor visits if they're medically necessary.

What are the 5 things Medicare does not cover?

Original Medicare (Parts A & B) doesn't cover most dental, vision (like glasses/contacts), hearing aids, routine foot care, and long-term custodial care, plus many alternative therapies, cosmetic surgeries, and prescription drugs (without Part D). You'll need supplemental plans (like Medigap or Part C) or separate insurance for these common needs. 

What does Medicare Part B Cover?

Does Medicare pay for a colonoscopy?

Yes, Medicare (Part B) pays for screening colonoscopies, covering 100% of costs if your doctor accepts assignment and no polyps are found, though you pay 15% if they remove tissue (making it diagnostic); frequency depends on your risk, generally every 10 years (average risk) or 24 months (high risk). 

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

Is it worth it to have Medicare Part B?

Yes, Medicare Part B is generally considered worth it for most people because it covers essential outpatient care like doctor visits, tests, and preventive services, but its value depends on your other insurance, income (due to IRMAA), and health needs, making it crucial for those without other coverage but potentially costly for high-income earners. It's vital if Medicare is your primary insurance (e.g., if you're over 65 with small employer coverage) to avoid large bills, but less beneficial if you have great employer coverage that coordinates well with Medicare, especially if you pay high income-related premiums (IRMAA). 

Does part B pay for surgery?

Yes, Medicare Part B covers medically necessary outpatient surgeries and physician services, including anesthesia and supplies, paying 80% of the Medicare-approved amount after your deductible, with you responsible for the remaining 20% coinsurance. Part A covers inpatient surgeries, while Part B handles outpatient procedures like those in ambulatory surgical centers or hospital outpatient departments, as long as the surgery treats a diagnosed condition and your doctor accepts Medicare. 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

How much does the average person pay for Medicare Part B?

For 2026, the standard Medicare Part B monthly premium is $202.90, with higher amounts for higher incomes, plus a $283 annual deductible before Medicare pays its share (typically 20%). Most people pay the standard rate if they sign up when first eligible and receive Social Security benefits.
 

Is there an income limit for Medicare Part B?

Medicare Part B has income limits, called IRMAA (Income-Related Monthly Adjustment Amount), where higher Modified Adjusted Gross Income (MAGI) leads to higher premiums, with 2026 brackets starting above $109,000 for individuals and $218,000 for couples, based on your 2024 tax return, with higher earnings pushing you into surcharges added to the standard $202.90 premium. For example, individuals earning over $109,000 (up to $137,000) pay the standard premium plus an $81.20 surcharge, while higher earners pay even more, with substantial jumps at higher income levels.
 

How much will Medicare Part B cost in 2025?

For 2025, the standard Medicare Part B premium is $185 per month, but this can be higher based on your income (Income-Related Monthly Adjustment Amount - IRMAA) or lower due to the "hold harmless" rule for some. The actual amount depends on your 2023 income and you might pay the standard $185, more if higher income, or potentially less if your Social Security benefit increase (COLA) was small and you're held harmless. 

Do I have a copay with Medicare Part B?

Yes, Medicare Part B typically involves a 20% coinsurance (which acts like a copay) for most services after you meet your annual deductible, not a fixed copay amount, meaning you pay 20% of the Medicare-approved amount for doctor visits, outpatient care, and medical supplies, while Medicare covers the other 80%. There's also a monthly premium, and the deductible (e.g., $283 in 2026) must be paid first. 

What medications will no longer be covered by Medicare?

Drugs never covered by Medicare

Drugs for anorexia, weight loss, or weight gain (i.e., Xenical®, Meridia, phentermine HCl, etc.) Drugs that promote fertility (i.e., Clomid, Gonal-f, Ovidrel®, Follistim®, etc.) Drugs for cosmetic purposes or hair growth (i.e., Propecia®, Renova®, Vaniqa®, etc.)

Does Medicare Part B cover blood pressure medication?

Unfortunately, Original Medicare (Part A and Part B) does not usually cover medication to treat high blood pressure. While Medicare Part B offers some prescription drug coverage, it has limited coverage of most drugs for chronic conditions, including high blood pressure. Learn more about Medicare Part B.

What are the four things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:

• A heart valve repair or replacement.
• An organ transplant.
• Cancer-related treatments.
• Dialysis services for the treatment of End-Stage Renal Disease (ESRD)

Does Medicare Part B cover 100%?

With Medicare Part B, you pay 20 percent of the cost for the services you use. So if your doctor charges $100 for a visit, then you are responsible for paying $20 and Part B pays $80. There is no limit on Part B coinsurance costs, which could add up if you have a lot of doctor visits or need other services.

Is anesthesia covered under part B?

Yes, Medicare Part B covers anesthesia for medically necessary outpatient procedures, including those in hospitals or ambulatory surgical centers, but you typically pay 20% coinsurance after your deductible, while Part A covers inpatient anesthesia. Coverage depends on the procedure's necessity, the provider's Medicare assignment, and the facility's status, with exclusions for most cosmetic or routine dental anesthesia. 

Why would someone not want Medicare Part B?

While Part A is generally premium-free for most individuals, Part B does come with a monthly premium. If your existing coverage is sufficient and you have no immediate need for the services covered under Part B, you may decide to delay enrollment to avoid paying unnecessary premiums.

Does everyone pay $170 for Medicare Part B?

Costs for Part B (Medical Insurance)

$185 each month ($202.90 in 2026) (or higher depending on your income). The amount can change each year. You'll pay the premium each month, even if you don't get any Part B-covered services.

Can you make too much money for Medicare Part B?

You cannot make too much money to qualify for Medicare. Eligibility is based on age or disability status, not income. That said, higher earnings can trigger income-based surcharges on premiums, particularly for Part B and Part D coverage.

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

What states have the worst Medicare Advantage plans?

States often cited for weaker Medicare Advantage performance include Louisiana, Mississippi, Kentucky, West Virginia, and Florida, due to challenges with care access, provider shortages, and quality issues like higher rates of avoidable hospitalizations and inappropriate medication prescriptions, though specific rankings vary by report and focus (e.g., satisfaction vs. overall system). Other states like New York, California, Texas, and Michigan appear on lists for low member satisfaction with specific plans, not necessarily the whole state's system. 

How to lower Medicare premiums?

To lower Medicare premiums, report income drops from life events like retirement (Form SSA-44), apply for low-income help like Extra Help or Medicaid, use HSA funds for premiums, deduct premiums from taxes, switch to a cheaper Medicare Advantage or Supplement plan, or check if you qualify for Medicare Savings Programs (MSPs) through your state.