Coverage Options
Medicare covers a wide range of healthcare services. Explore each category below to understand exactly what is covered and how it works.
What Medicare Covers
From hospital stays to preventive screenings, here is a complete look at the services Medicare helps pay for.
Hospital Care
Inpatient care when you are formally admitted to a hospital. Medicare Part A covers your room, meals, nursing services, medications administered during your stay, and other hospital services and supplies.
Covered Services Include:
- Semi-private room and meals
- General nursing care
- Drugs as part of your inpatient treatment
- Other hospital services and supplies
- Inpatient mental health care in a psychiatric hospital up to 190 days in a lifetime
Doctor Visits & Outpatient Care
Medicare Part B covers medically necessary doctor visits and outpatient services. This includes appointments with your primary care doctor, specialists, and many preventive services.
Covered Services Include:
- Primary care doctor visits
- Specialist consultations
- Outpatient surgeries and procedures
- Lab tests and X-rays
- Emergency room visits not resulting in admission
- Preventive screenings and annual wellness visits
Prescription Drug Coverage
Medicare Part D and many Medicare Advantage plans help cover the cost of your prescription medications. Each plan has a formulary that lists which drugs are covered.
Covered Services Include:
- Brand-name and generic prescription drugs
- Medications for chronic conditions like diabetes, high blood pressure, and arthritis
- Most vaccines not covered by Part B
- Wide network of pharmacies including major chains and local independents
- Mail-order pharmacy options for convenience and savings
Preventive Services
Medicare covers a wide range of preventive services at no cost to you. These services help detect health problems early when treatment works best.
Covered Services Include:
- Annual wellness visit with your doctor
- Cardiovascular disease screenings
- Diabetes screenings and self-management training
- Cancer screenings including mammograms, colonoscopies, and prostate exams
- Flu shots, pneumonia shots, and COVID-19 vaccines
- Depression screenings and counseling
- Bone mass measurements for osteoporosis
Home Health Care
Medicare covers eligible home health services when you are homebound and need skilled nursing care or therapy on a part-time basis. These services are provided in the comfort of your own home.
Covered Services Include:
- Part-time skilled nursing care
- Physical therapy, occupational therapy, and speech-language pathology
- Medical social services
- Part-time home health aide services
- Durable medical equipment for home use
Skilled Nursing Facility Care
Medicare Part A covers skilled nursing facility care for a limited time when you need daily skilled care after a qualifying hospital stay of at least 3 days.
Covered Services Include:
- Semi-private room and meals
- Skilled nursing care and rehabilitation services
- Physical, occupational, and speech therapy
- Medications administered during your stay
- Medical supplies and equipment used in the facility
- Dietary counseling and social services
Durable Medical Equipment
Medicare Part B covers medically necessary durable medical equipment that your doctor prescribes for use in your home. These items must be reusable and serve a medical purpose.
Covered Services Include:
- Walkers, canes, and wheelchairs
- Hospital beds and patient lifts
- Oxygen equipment and supplies
- Blood sugar monitors and test strips
- CPAP machines for sleep apnea
- Nebulizers and related medications
Mental Health Services
Medicare covers a range of mental health services including both inpatient and outpatient care. Taking care of your mental health is just as important as your physical health.
Covered Services Include:
- Outpatient counseling and therapy sessions
- Psychiatric evaluations and medication management
- Inpatient mental health care
- Partial hospitalization programs
- Annual depression screening at no cost
- Alcohol and substance use disorder treatment
Have Questions About Your Coverage?
Every situation is different. Let us review your needs and help you understand exactly what is covered and what your costs will be.