Your Medicare Coverage

Is my test, item, or service covered?

Outpatient hospital services

How often is it covered?

Medicare Part B (Medical Insurance) covers medically necessary diagnostic and treatment services you get as an outpatient from a Medicare-participating hospital. Covered outpatient hospital services may include:

Who's eligible?

All people with Medicare are covered.

Your costs in Original Medicare

  • You generally pay 20% of the Medicare-approved amount for the doctor or other health care provider's services, and the Part B deductible applies.
  • For all other services, you also generally pay a copayment for each service you get in an outpatient hospital setting. You may pay more for services you get in a hospital outpatient setting than you would pay for the same care in a doctor's office.
  • For some screenings and preventive services, coinsurance, copayments, and the Part B deductible don't apply (so you pay nothing).
Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Related resources

Return to search results