Medicare.gov

Doctor & other health care provider services

Medicare Part B (Medical Insurance) covers medically necessary doctor services and most  preventive services.

  • Covered by Part B
  • Usually 20% of the Medicare-approved amount

Description

A doctor can be:

  • A Doctor of Medicine (MD)
  • A Doctor of Osteopathic Medicine (DO)
  • In some cases, a dentist, podiatrist (foot doctor), optometrist (eye doctor), or chiropractic

Medicare also covers services you get from other health care providers, like:

  • Clinical nurse specialists
  • Clinical psychologists
  • Clinical social workers
  • Marriage and family therapists
  • Mental health counselors
  • Nurse practitioners
  • Occupational therapists
  • Physician assistants
  • Physical therapists
  • Speech-language pathologists 

Coverage details

Part B covers medically necessary doctor services (including outpatient services and some inpatient hospital doctor services you get when you’re a hospital inpatient) and most preventive services.  

If you haven’t gotten services from your doctor or group practice in the last 3 years, they may consider you a new patient. Check with the doctor or group practice to find out if they’re accepting new patients. 

Costs

After you meet the Part B deductible , you pay 20% of the  Medicare-approved amount for most services. You pay nothing for certain preventive services if your doctor or other provider accepts   assignment

Ask your doctor or healthcare provider how much your test, item, or service will cost.

Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.

Specific amounts you could owe depend on:

  • Other insurance you may have

  • How much your doctor charges

  • If your doctor accepts assignment

  • The type of facility

  • Where you get your test, item, or service