The Medicare program can be very confusing, even when it comes to seemingly basic questions like “What does Medicare cover?”

What Is Medicare?

Medicare is basically a government run health care insurance program. Those in the US who are 65 and older are eligible for coverage. Though some younger than 65 with disabilities may qualify.

What Does Medicare Cover?

Medicare covers a wide range of medical and health related products, services and treatments. What exactly is covered depends on a few key factors. They are:

  • What kind of Medicare coverage you have
  • Where you live
  • The reason you need the product, service and/or treatment

Let’s dig a little deeper into each of these factors below.

What Kind of Medicare Coverage You Have

There are a number of different types or parts of Medicare coverage. You may have heard about Part A, Part B, etc. when it comes to Medicare. Each one of those covers different things. Here is an overview of what each part covers.

Part A

Inpatient Hospital Care

This covers inpatient care at long-term hospitals, inpatient mental health hospitals, critical access hospitals and acute care hospitals.

In these settings, Medicare Part A will typically cover: a semi-private room, meals, general nursing care, physical therapy, occupational therapy, prescription drugs/medical supplies, specialty unit care (ie. Intensive care) , lab/imaging tests and operating room services.

Skilled Nursing Home Facility Care

If a stay at a skilled nursing facility is required, Medicare Part A generally covers: a semi-private room, meals, skilled nursing care, prescription drugs/medical supplies, ambulance transport (if medically required).

Nursing Home Care

Medicare Part A may cover nursing home care for a limited time if skilled nursing care is required. The usual coverage includes: a semi-private room, meals, general nursing care, physical therapy, occupational therapy, and prescription drugs/medical supplies

Hospice Care

Part A also covers hospice care for those with a terminal illness with less than 6 months to live. The specific things covered for hospice include: care to manage symptoms/control pain for those with terminal illness, prescription drugs/medical supplies, general nursing care, and doctor services.

Home Health Care

Home health care coverage is limited to those who have been discharged from an inpatient hospital stay but still require care during recovery. In this situation, Medicare Part A typically covers: physical therapy, occupational therapy, skilled healthcare, and prescription drugs/medical supplies.

Part B

Next we’ll look at what Medicare Part B covers. Broadly, Part B covers medically necessary services like outpatient care as well as preventative services.

The list below is a partial list of what Part B covers. For a complete, updated list of what’s covered visit the official Medicare website.

  • Doctor visits
  • Some prescription drug coverage
  • Vaccines including flu, tetanus, Hepatitis B and pneumonia shots
  • Emergency Department services
  • Home health services
  • Physical therapy / Occupational therapy
  • Mammograms
  • Ambulance services
  • Chiropractic treatment
  • Mental health services
  • Some medical equipment like walkers and hospital beds
  • Outpatient Medical & Surgical Services
  • Smoking Cessation
  • Telehealth
  • Some lab tests
  • Annual wellness visit with your primary care provider
  • Some cancer screenings
  • Diabetes screening, supplies and services and, if you qualify, prevention program
  • Depression screenings
  • Alcohol abuse screenings and counseling

Part C

Medicare Part C is offered by private health insurance companies. It’s also known as Medicare Advantage. It covers what Parts A & B do but can also offers some extra services and benefits the other Parts don’t.

In addition to what Part A & B cover, Part C may cover:

  • Prescription drugs you take at home
  • Dental care including routine cleanings, x-rays and dentures
  • Vision care that may include contacts and eyeglasses
  • Hearing care that may include hearing aids
  • It may also provide gym memberships and meal delivery services

Part D

Lastly we come to Medicare Part D. Part D is basically prescription drug coverage. It is offered by private insurance companies. This means the specific drugs covered will differ from plan to plan (though the government does have minimum coverage requirements). Which drugs are covered also depends on what tier of coverage you get.

Also important to know is, no matter what plan you have, Medicare Part D only covers FDA approved prescription drugs.

Where You Live

Your Medicare coverage and what Medicare will pay for can depend on where you live. Your “Original” Medicare coverage – Parts A and B – are national plans. The basic coverage they provide is standard across the United States.

However, that’s not the case with Medicare Advantage plans and Prescription Drug plans offered by private insurance. Coverage for these plans, their costs, what they cover, etc. may vary depending on what state you live in.

Your Reason for Needing a Treatment, Product or Medical Service

What Medicare will cover also depends on why you need a specific treatment, product or medical service.

Let’s take shoe inserts for example. Medicare won’t cover shoe inserts for just anyone. But it will if you need them due to diabetes and severe diabetic foot disease.

Consult with your medical provider to see if their recommended treatment, etc. is covered for someone who has your condition, disease or illness.

A Look At Common Treatments, Medical Services and More That Medicare Covers

People have questions about Medicare coverage for all sorts of specific treatments, services and more. Below you’ll find an ever-growing list of them that you can click on to find out whether Medicare will pay for them. You’ll also find info on costs and pricing as well as some helpful background info about each. We hope you find this useful!

3-D Mammograms

Accu Chek Test Strips

Accutane

Acne Treatment

Acupuncture

Adjustable Beds

Alcohol Rehab

Allergy Immunotherapy

Allergy Shots

Ambulance Services

Ambulance Transport

Annual Physicals

Antivenom

Appendix Surgery

Aquablation

Armour Thyroid

Artificial Insemination

Assisted Living

Assisted Living for Dementia

Asthma Inhalers

Audiology

Autism Services

B12 Shots

Back Braces

Back Surgery

BAHA Implants

Bariatric Surgery

Bathroom Remodeling

Bed Alarms

Beovu

Bioness L300

Birth Control

Blood Pressure Monitors

Blood Tests

Blood Transfusions

Blood Work

Bone Density Test

Bond Grafts

Boniva

Botox for Hyperhidrosis

Botox for Migraines

Botox for Overactive Bladder

Braces

Brain Scans

BRCA1 and BRCA2 Testing

Breast Protheses

Breast Reduction

Bronchial Thermoplasty

Bunion Surgery

Bypass Surgery

Cancer Treatment

Cancer Treatment After Age 76

Car Accident Injuries

Caregivers

Carpal Tunnel Surgery

CAR-T Therapy

Cataract Surgery

Chantix

Chemo Infusions

Chemo Treatments

Chemotherapy

Chest X Rays

Chiropractic Visits

Cialis

Clarifix

Cochlear Implants

Cochlear Implant Batteries

Colonoscopy

Companion Care

Compounded Drugs

Compression Sleeves

Compression Stockings

Coolief Knee Treatment

Cornea Transplants

Corneal Cross-Linking

Cortisone Injections

Counseling

Covid Testing

CPAP

CPAP Cleaning Machines

CPAP Machines

CPAP Masks

CPAP Supplies

Cruise Ship Claims

Day Care

DBT Therapy

Dementia Care

Dementia Care At Home

Dental

Dentures

Denosumab Injections

Depends

Dermatology

Deviated Septum Surgery

Dexilant

Dexcom G6

Diabetic Shoes

Diabetic Supplies

Diabetic Test Strips

Dialysis

Dietitians

Doctor’s Visits

Dog Bites

Drug Rehab

Dry Needle Therapy

Durolane Injections

Eating Disorder Treatment

Echocardiogram

Electric Scooters

Electric Wheelchairs

Eliquis

EMDR Therapy

Emergency Room Visits / ER Visits

Enbrel

Endoscopy

Epiretinal Membrane Surgery

Exercise Bikes

Exercise Programs

Eye and Dental

Eye Drops for Cataract Surgery

Eye Exams for Cataracts

Eye Refraction

Eye Surgery

Eyeglasses

Eyelid Surgery

Facial Feminization Surgery

Fasenra

Food Allergy Testing

Flu Shots

FoundationOne Testing

FreeStyle Libre 14 Day

Funeral Expenses

Gastric Bypass Surgery

Gastric Sleeve Revision

Gender Reassignment Surgery

Genetic Testing For Cancer

Glasses

Glasses After Cataract Surgery

Glaucoma Laser Surgery

Glaucoma Treatment

Grab Bars

Green Light Laser Therapy

Grief Counseling

Gym Memberships

Hair Loss Treatment

Hand Surgery

Handicap Showers

Handicap Vans

Hearing Tests

Heavy Metal Testing

Hemorrhoid Surgery

Hepatitis A Vaccines

Hepatitis C Screening

Hernia Surgery

Hernia Repair

HIFU

Hip Replacement

Home Health

Home Health Care

Home Health Aides

Home Ramps

Home Sleep Study

Hormone Pellets

Hormone Replacement Therapy

Hospice at Home

Hospital Bed Sheets

Hospital Beds

Hospital Stays

HPV Testing

Hyaluronic Acid Injections

Hyperbaric Chamber

Hyperbaric Oxygen Therapy

Hyperbaric Treatment

Hypnotherapy

Ice Machines

Imbruvica

Immediate Care

Immunotherapy for Cancer

In Vitro Fertilization

In-Home Care

Infertility

Infrared Therapy

Inogen Oxygen Concentrators

Insulin Pumps

Insulin Pumps For Type 2 Diabetes

Intravenous Iron Therapy

InterDry

Intermittent Catheters

Invisalign

IVIG For CIDP

Ketamine Infusion for Depression

Knee Braces

Kyphoplasty

Lab Work

Lap Band Surgery

Laser Back Surgery

Laser Cataract Surgery

Laser Hair Removal

Laser Therapy

Laser Treatment for Toenail Fungus

LASIK Eye Surgery

Life Alert

Life Flight

Life Vest Defibrillators

Lift Chair Rental

LINX Surgery

LipiFlow Treatment

Long Term Care

Lovenox Injections

Lyme Disease Treatment

Macular Degeneration Treatment

Mammograms

Mandibular Advancement Devices

Marriage Counseling

Massage / Massage Therapy

Mattresses

Medical Alert Systems

Medical Bathroom Equipment

Medical Expenses Abroad

Medical Transportation

Medtronic 670g

Memory Care

Mental Health

Methadone

Methadone Treatment

MinuteClinic Visits

Mobility Scooters

Mohs Surgery

Mole Removal

Mouth Guards for Sleep Apnea

MRI Guided Prostate Biopsy

MRI of the Brain

MRI of Shoulders

Multifocal Lenses for Cataract Surgery

Naturopathic Care

Naturopathic Doctors

Nebulizers

Needle Aponeurotomy

Neuropathy Shoes

Neurostar

Non-FDA Approved Drugs

NP Thyroid

Nuclear Stress Test

Nursing Home Care

Nursing Homes

Nutritional Counseling For Obesity

Nutritionists

OB-GYN

Omnipod Dash

Oncotype DX Test

Opdivo

Ophthalmologists

Optifast Weight Loss Programs

Optune

Oral Surgery

Orencia

Orthopedic Surgery

Orthotics for Plantar Fasciitis

Over The Counter Drugs

Oxygen in a Nursing Home

Palliative Care

Panniculectomy

Pap Smear Test

Patient Lifts

PCA3 Tests

Pedicures

Pelvic Floor Physical Therapy

Penile Implants

Periodontal Disease

Phone Consultations

Physical Therapy

Physical Therapy At Home

Physical Therapy for Back Pain

Plantar Fasciitis

Plastic Surgery

Pneumonia Shots

Pneumonia Vaccines

Podiatry

Podiatry For Diabetics

Podiatry Visits

Portable Oxygen Concentrators

Power Lift Recliners

Power Wheelchairs

Pregnancy

Preventive Services

Prolia

Promacta

Prosthetic Eyes

PRP Injections

Psychiatric Hospitalization

Psychological Therapy

Psychotherapy

Purewick

Rabies Vaccine

Radiation

Radicava

Raised Toilet Seats

Reconstruction After Mohs Surgery

Refraction Exam

Regenerative Medicine

Rehab

Rehab After Knee Surgery

Respite Care

Restasis

RFA

Rituxan

Robotic Surgery

Rollators

Root Canals

Routine Foot Care

Second Opinions

Scleral Lenses

Sclerotherapy

Scooters

Screening DEXA Scans

Seat Cushions

Secondary Cataract Surgery

Septoplasty

Service Dogs

Shingles Vaccine

Shingrix

Shock Wave Therapy

Shoe Inserts

Shower Chairs

Silver Sneakers

Skilled Nursing

Skilled Nursing At Home

Skin Cancer

Skin Cancer Screening

Skin Removal Surgery

Skin Tag Removal

Sleep Apnea Oral Appliances

Sleep Number Beds

Sleep Study

Sleeve Gastrectomy

SoClean CPAP Cleaner

Stair Lifts

Stem Cell Therapy

Stem Cell Therapy For COPD

Stem Cell Therapy for Shoulders

Stem Cell Transplant For Lymphoma

Support Hose

Support Stockings

Synvisc Injections

Tdap Immunization

Telemedicine

Telepsychiatry

TENS Units

Test Strips for Diabetes

Testopel

Testosterone Pellets

Therapeutic Phlebotomy

Therapy

Thermography

Thyrogen Injections

Thyroid Blood Test

TMJ Problems

TMS for Depression

Toenail Fungus Treatment

Toilet Seat Risers

Tooth Extractions

Tooth Implants

Tori Removal

Total Knee Replacement Surgery

Transportation

Treatment for Peyronie’s disease

Trelegy

Tummy Tucks

Urgent Care

UroLift Procedure

US Citizens Living Abroad

Vaccines

Vasectomy

Vectra DA Test

Vestibular Therapy

Viagra

Victrectomy Chairs

Virtual Visits

Viscosupplementation Injections

Vision and Dental

Visual Field Testing

Walkers

Walk-in Clinics

Walk-in Showers

Walk-in Tubs

Wart Removal

Weight Loss Programs

Weight Loss Revision Surgery

Weight Loss Surgeries

Weighted Blankets

Wheelchairs

Wheelchair Ramps

Wigs for Alopecia

Wigs for Cancer Patients

Wisdom Teeth

Xolair Injections

Xtandi

Yearly Physical Exams

YMCA Memberships

Yoga

Zilretta

Zostavax

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