The supplementary medical insurance plan covers expenses incurred for the following medical and other health services under Part B of Medicare:
• Physician’s services, including surgery, consultation, office and institutional calls, and services and supplies furnished incident to a physician’s professional service;
• Outpatient hospital services furnished incident to physicians services;
• Outpatient diagnostic services furnished by a hospital;
• Outpatient physical therapy, outpatient occupational therapy, outpatient speech-language pathology services;
• Diagnostic x-ray tests, laboratory tests, and other diagnostic tests;
• X-ray, radium, and radioactive isotope therapy;
• Surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations;
• Rental or purchase of durable medical equipment for use in the patient’s home;
• Ambulance service;
• Prosthetic devices, other than dental, which replace all or part of an internal body organ;
• Leg, arm, back and neck braces and artificial legs, arms, and eyes including adjustments, repairs, and replacements required because of breakage, wear, loss, or change in the patient’s physical condition;
• Certain medical supplies used in connection with home dialysis delivery systems;
• Rural health clinic (RHC) services;
• Federally Qualified Health Center (FQHC) services;
• Ambulatory surgical center (ASC) services;
• Screening mammography services;
• Screening pap smears and pelvic exams;
• Screening glaucoma services;
• Influenza, pneumococcal pneumonia, and hepatitis B vaccines;
• Colorectal screening;
• Bone mass measurements;
• Diabetes self-management services;
• Prostate screening; and
• Home health visits after all covered Part A visits have been used.