Doctor & other health care provider services
Medicare Coverage Information
Overview
Medicare covers a wide range of doctor and healthcare provider services through Medicare Part B, including preventive care, specialist consultations, and medically necessary treatments. Beneficiaries typically pay a portion of the costs through deductibles and coinsurance.
- Covers doctor office visits, specialist consultations, and preventive services
- Includes both in-person and telehealth medical consultations
- Requires medical necessity for most non-preventive services
- Beneficiaries are responsible for copayments and deductibles
- Covers services from licensed healthcare providers and specialists
- Available to individuals 65+ enrolled in Medicare Part B
- Younger individuals with certain disabilities can also qualify
- U.S. citizens and permanent residents meeting Medicare requirements
- Annual Part B deductible applies before Medicare coverage begins
- Typically pays 80% of approved medical service costs
- Beneficiaries responsible for 20% coinsurance after meeting deductible
- Some preventive services may be covered at 100% with no out-of-pocket costs
- Services must be deemed medically necessary
- Only covers services provided by Medicare-approved healthcare providers
- Some specialized treatments may require prior authorization
- Cosmetic procedures are generally not covered
- Verify provider accepts Medicare assignment
- Review your specific Medicare plan details
- Confirm coverage for specific medical services before treatment
- Contact 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare doctor serviceshealthcare provider coverageMedicare Part Bmedical visitsphysician services
Related Coverage Topics
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