Medicare Coverage
Part B helps cover medically-necessary services like doctors’ services, outpatient care, and other medical services that Part A doesn’t cover. Part B also covers some preventive services.
Covered Services and Items
Subject to certain restrictions, Medicare Part B covers the following services and items when medically reasonable and necessary:
* Physician services, including
o Surgery
o Consultation
o Office and institutional visits
o Services and supplies furnished “incident to” physician professional services
* Ambulance service
* Approved ambulatory surgical center (ASC) services
* Artificial legs, arms and eyes
* Certified physician assistant services
* Clinical psychologist and licensed clinical social worker services
* Diagnostic x-ray tests, laboratory tests, and other diagnostic tests
* Leg, arm, back and neck braces
* Nurse practitioner, nurse midwife, certified registered nurse anesthetists, and clinical nurse specialist services
* Physical, occupational and speech therapy services
* Prescription Drugs – Coverage for prescription drugs is now covered under Medicare Part D. Please contact your prescription drug plan for details.
* Preventive Services – For information on these, visit the Medicare website.
* Prosthetic devices to replace all or part of a body organ
* Rental or purchase of durable medical equipment
* Surgical dressings, splints, casts, and other devices used for reduction of fractures and dislocations
* X-ray, radium, and isotope therapy
Noncovered (Excluded) Services and Items
Medicare provides basic health care coverage, but it does not pay all medical expenses. Noncovered Medicare services include:
* Any chiropractic service, except for treatment of subluxation of the spine
* Cosmetic surgery
* Custodial care
* Dental care and dentures
* Extra charges for a private room
* Full-time nursing care in the home
* Most eyeglasses and eye exams
* Most immunization shots (except the pneumonia vaccine, flu vaccine and Hepatitis B vaccine)
* Nursing home care
* Over-the-counter drugs
* Personal comfort items
* Private duty nurse
* Routine foot care
* Tests for fitting hearing aids or the hearing aids
