How to get Medicare services

When you get health services or fill prescriptions, you’ll need to show that you have Medicare so we (or your plan) can pay your claims .

If you have: You should bring your:
Original Medicare Medicare card
Medicare Advantage Plan Plan card instead of your Medicare card
Medicare drug plan Plan card when you fill prescriptions (Also bring proof of Medicaid or that you qualify for Extra Help , if you get these programs.)
Supplemental coverage (like employer or retiree plan or a Medicare Supplemental Insurance (Medigap) policy ) Plan card and your Medicare card

If you forget your Medicare card, log into your secure Medicare account and select “Print My Medicare Card” to show a copy of your card to your provider. Plans may offer online accounts to view your plan card.

Tell us if you have other health insurance so we can pay your claims properly. Call Medicare’s Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627. TTY users can call 1-855-797-2627. Check how Medicare works with your other insurance.

Does my doctor or provider take Medicare? 

If you have:

Do this:

Original Medicare

Before you get services, ask your health care provider if they charge the Medicare-approved amount (so you pay less out-of-pocket).

  • If they do, you won’t be billed for more than the Medicare deductible and coinsurance.
  • If they don’t, they can charge you more than the Medicare-approved amount. You might have to pay the full cost at the time of service.

Compare Medicare providers in your area.

Medicare Advantage Plan (Part C)

Check with your plan to find out if they have a “ network ” and if your provider is “in-network.”

  • Some plans allow you to use providers “out-of-network,” but you usually have to pay a higher share of the costs.
  • You can always get emergency care and urgent care when needed, even if the doctor or hospital isn’t “in-network.”

Medicare drug coverage (Part D)

Check with your plan to find out what pharmacies in your area are “in-network.” In-network pharmacies are “preferred” or “standard.”

  • “Preferred” pharmacies usually offer the lowest cost for drugs.
  • If you use an ”out-of-network” pharmacy, you might have to pay the full cost.

Log into your account to get your plan details and drug costs.

If you need or get help with costs, have Medicaid, or have a disability, find programs and resources to help you with your Medicare coverage.

 

What does Medicare cover?

Check if Medicare covers your test, item, or service. Or, download our "What's covered?" mobile app to your smart phone or tablet to quickly find covered services. If something isn't covered, talk to your doctor or other health care provider about why you need it. 

Medicare covers services that are medically necessary.

  • Part A (Hospital Insurance) helps cover inpatient care in a hospital, skilled nursing facility care, hospice care, and some home health care.
  • Part B (Medical Insurance) generally helps cover:
    • Services or supplies needed to diagnose or treat your medical condition (like services from doctors or other health care providers, home health care, durable medical equipment , and more).
    • Preventive services to prevent illnesses (like getting a flu shot) or detect illnesses early (like cancer screenings). You pay $0 for most preventive services if your provider accepts the Medicare-approved amount as full payment.

Get more details on what Medicare covers.

What Medicare Advantage Plans & drug plans cover

  • Medicare Advantage Plans must cover all of the services that Original Medicare covers, and may offer some extra benefits — like vision, hearing, and dental services.
  • All plans with drug coverage must cover a wide range of prescription drugs that people with Medicare take, like drugs to treat diabetes.
  • Check with your plan to get specific information on what it covers.

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