Chris Clark January 29, 2021 179 Comments

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

Adjustable Beds

Alcohol Rehab

Allergy Shots

Ambulance Services

Ambulance Transport

Annual Physicals

Appendix Surgery

Assisted Living

Assisted Living for Dementia

Asthma Inhalers

Back Braces

Bariatric Surgery

Bathroom Remodeling

Blood Pressure Monitors

Blood Tests

Bone Density Test

Boniva

Botox for Migraines

Braces

Breast Reduction

Bunion Surgery

Cancer Treatment

Car Accident Injuries

Carpal Tunnel Surgery

Cataract Surgery

Chantix

Chemotherapy

Chest X Rays

Chiropractic Visits

Cialis

Cochlear Implants

Cochlear Implant Batteries

Colonoscopy

Compounded Drugs

Compression Sleeves

Compression Stockings

Coolief Knee Treatment

Corneal Cross-Linking

Counseling

CPAP

CPAP Cleaning Machines

CPAP Machines

CPAP Masks

CPAP Supplies

Cruise Ship Claims

Dementia Care

Depends

Dermatology

Dexcom G6

Diabetic Shoes

Diabetic Supplies

Dietitians

Dog Bites

Drug Rehab

Dry Needle Therapy

Eating Disorder Treatment

Echocardiogram

Electric Scooters

Emergency Room Visits / ER Visits

Endoscopy

Eye Surgery

Eyeglasses

Eyelid Surgery

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

Grab Bars

Green Light Laser Therapy

Gym Memberships

Handicap Vans

Hemorrhoid Surgery

Hernia Surgery

HIFU

Hip Replacement

Home Health Aides

Home Ramps

Hospital Beds

Hyperbaric Oxygen Therapy

Hypnotherapy

Ice Machines

Infrared Therapy

Inogen Oxygen Concentrators

Insulin Pumps For Type 2 Diabetes

Intravenous Iron Therapy

Intermittent Catheters

Invisalign

Ketamine Infusion for Depression

Knee Braces

Lab Work

Laser Cataract Surgery

Laser Hair Removal

LASIK Eye Surgery

Life Alert

Life Flight

Lift Chair Rental

LipiFlow Treatment

Lyme Disease Treatment

Mammograms

Mandibular Advancement Devices

Marriage Counseling

Massage / Massage Therapy

Mattresses

Medical Bathroom Equipment

Medical Expenses Abroad

Medical Transportation

Mental Health

Mobility Scooters

Mouth Guards for Sleep Apnea

Naturopathic Care

Naturopathic Doctors

Nebulizers

Needle Aponeurotomy

Neuropathy Shoes

Neurostar

Nutritionists

Oral Surgery

Orthotics for Plantar Fasciitis

Over The Counter Drugs

Palliative Care

Pap Smear Test

Patient Lifts

Pedicures

Physical Therapy for Back Pain

Plantar Fasciitis

Podiatry

Podiatry Visits

Portable Oxygen Concentrators

Power Lift Recliners

Prolia

Promacta

Prosthetic Eyes

PRP Injections

Psychological Therapy

Psychotherapy

Radiation

Radicava

Raised Toilet Seats

Regenerative Medicine

Rehab

Respite Care

Rituxan

Rollators

Scleral Lenses

Sclerotherapy

Scooters

Screening DEXA Scans

Seat Cushions

Secondary Cataract Surgery

Septoplasty

Service Dogs

Shingles Vaccine

Shingrix

Shoe Inserts

Shower Chairs

Silver Sneakers

Skilled Nursing

Skin Cancer Screening

Skin Removal Surgery

Sleep Apnea Oral Appliances

Sleep Study

Stair Lifts

Stem Cell Therapy

Stem Cell Therapy For COPD

Stem Cell Therapy for Shoulders

Support Hose

Support Stockings

Synvisc Injections

Tdap Immunization

TENS Units

Therapy

TMS for Depression

Toilet Seat Risers

Tooth Implants

Tori Removal

Transportation

Tummy Tucks

Urgent Care

Vestibular Therapy

Viagra

Victrectomy Chairs

Visual Field Testing

Walkers

Walk-in Showers

Walk-in Tubs

Weight Loss Programs

Weight Loss Surgeries

Weighted Blankets

Wheelchair Ramps

Wigs for Alopecia

Wigs for Cancer Patients

Xolair Injections

Zostavax

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