Medicare covers a number of inpatient and outpatient procedures. Find out if your procedure will be covered by Medicare, how much it may cost and what you can do to get help paying for it.
Medicare covers a number of inpatient and outpatient procedures. Find out if your procedure will be covered by Medicare, how much it may cost and what you can do to get help paying for it.
Procedures Medicare does cover
Medicare Part A and Part B make up what is known as “Original Medicare.”
Part A provides coverage for inpatient hospital services.
Part B covers outpatient care and durable medical equipment (DME).
Original Medicare coverage typically requires the care to be “medically necessary” in order for it to be covered by Part A or Part B. Certain other restrictions may apply, depending on the procedure you need.
Depending on the type of service you get and how Medicare covers it, you may face certain deductible, coinsurance and/or copayment costs.
The services and items below are not necessarily a complete list of procedures that are covered by Original Medicare.
Procedures Medicare typically doesn't cover may be covered by some Medicare Advantage plans
Some procedures that aren't typically covered by Original Medicare may sometimes be covered by certain Medicare Advantage (Medicare Part C) plans. Some common services, like hearing aids, aren't covered by Original Medicare.
All Medicare Advantage plans are required by law to provide all of the same benefits found under Original Medicare.
Check with your Medicare Advantage plan carrier or a licensed insurance agent for help determining which procedures, services and items may be covered by your Medicare Advantage plan or a plan in your area.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
Original Medicare (Parts A and B) doesn’t cover routine dental or vision care. 2024 Medicare Advantage (Part C) plans can cover benefits Original Medicare doesn’t cover, but dental and/or hearing benefits may not be available where you live. Learn more and find out how to compare the plans and benefits available in your area.
Medicare Part B may cover emergency ambulance services, and some Medicare Advantage plans may offer non-emergency transportation to plan-approved locations. Learn more about Medicare transportation coverage.
Medicare Advantage plans can offer gym memberships and fitness benefits that Original Medicare doesn’t cover, such as SilverSneakers. Learn how to compare your local plan options and how to find a Medicare Advantage plan that covers fitness benefits.
While Original Medicare (Parts A and B) doesn’t cover hearing aids, Medicare Advantage (Part C) plans can cover hearing benefits Original Medicare doesn’t cover. Hearing benefits may be available where you live, so learn how to find out if Medicare Advantage plans that help pay for hearing aids are available in your area.
Medicare Part B covers annual wellness visits. Medicare Advantage plans also cover annual wellness visits, and many Medicare Advantage plans also offer other wellness benefits not found in Original Medicare.
Medicare Part A does not cover outpatient surgery, but Part B covers medically necessary outpatient surgery. Medicare Advantage plans may also cover outpatient surgery and include an annual out-of-pocket spending limit, which Original Medicare doesn’t offer.
Original Medicare and Medicare Advantage plans can cover chiropractic care, but some plans may cover services more than others. Learn about what’s covered, what’s excluded and how much your Medicare costs could be.
Medicare covers many telehealth services, and those benefits expanded during the coronavirus pandemic. Beneficiaries can use telehealth to access their doctor while also staying safe during COVID-19.
Original Medicare (Medicare Parts A and B) doesn’t cover bathroom grab bars or other bathroom safety devices. Medicare Advantage plans can cover bathroom safety devices, but only in limited situations and only for beneficiaries who qualify.
Original Medicare covers some limited home health services. Medicare Advantage plans cover the same home health care services and may include some additional benefits.
Join our email series to receive your Medicare guide and the latest information about Medicare.
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Your Medicare guide will arrive in your email inbox shortly. You can also look forward to informative email updates about Medicare and Medicare Advantage.
If you'd like to speak with an agent right away, we're standing by for that as well. Give us a call!