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
- Surgery
- Consultation
- Office and institutional visits
- 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
Payment may not be made under Part B for services rendered to a patient
who is entitled to have payment made for those services under Medicare
Part A.
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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
In most cases, a physician or supplier may collect charges from
you for services that are completely denied as not covered by Medicare,
even though assignment was accepted.
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Articles
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02/07/2008
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