Parts of Medicare

Medicare benefits come in four categories - A, B, C, and D. Here's a breakdown of each part and its function, what it costs, and what it covers.

  • Medicare Part A - Hospital and other facility care (Original Medicare)
  • Medicare Part B - Doctors, outpatient hospital, medical equipment, therapy (Original Medicare)
  • Medicare Part C - Medicare Advantage, which is Original Medicare plus additional coverage - provided by health insurance companies
  • Medicare Part D - Medicare Part D prescription drug coverage provided by health insurance companies

Medicare Part B

Medicare Part B helps pay for doctors, outpatient hospital care, durable medical equipment, and some medical care that Part A doesn't cover, like physical and occupational therapy. Most people pay a monthly premium for Part B coverage.

Costs of Medicare Part B

  • You pay the Medicare Part B premium each month - most often this is deducted from your Social Security check
  • You also pay an annual Part B deductible before Medicare starts to pay its share
  • The Part B deductible and premium rates may change every year in January

You may be able to get help from Medicaid to pay your Part B premium and deductible. For more details, see Extra Help with Medicare Costs.

What Medicare Part B covers

Medical and other services

  • Doctors' services, but not routine physical exams except for a "Welcome to Medicare" one-time physical exam within the first six months you have Part B
  • Outpatient medical and surgical services and supplies
  • Diagnostic tests
  • Ambulatory surgery center facility fees for approved procedures
  • Durable medical equipment, including wheelchairs, hospital beds, oxygen, and walkers
  • A second - and sometimes a third - surgical opinion for non-emergency surgery that isn't an emergency (in some cases)
  • Outpatient mental healthcare
  • Outpatient occupational and physical therapy, including speech-language pathology

Clinical laboratory services

  • Blood tests
  • Urinalysis
  • Some screening tests and more

Home health care

  • Reasonable and necessary part-time or intermittent skilled nursing care and home health aide services
  • Physical therapy, occupational therapy, and speech-language pathology ordered by your doctor and provided by a Medicare-certified home health agency
  • When skilled nursing care or therapy services are being provided, home health aide services may also be covered if needed
  • Medical social services
  • Durable medical equipment, including wheelchairs, hospital beds, oxygen, and walkers
  • Medical supplies and other services

Outpatient hospital services

Hospital services and supplies received as an outpatient as part of a doctor's care.

Blood

Pints of blood you receive as an outpatient or as part of a Part B-covered service.

Watch Healthcare Video: What is Medicare?