Your Medicare Coverage
Is my test, item, or service covered?
How often is it covered?
All people with Medicare Part A and/or Part B are covered.
Your costs in Original Medicare
- As an inpatient, you pay the Part A deductible and coinsurance (if applicable).
- As an outpatient, you pay a copayment, and the Part B deductible applies.
- For therapy at a freestanding facility, you pay 20% of the Medicare-approved amount for the therapy, and the Part B deductible applies.
To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.