Your Medicare Coverage
Find out what Medicare covers
Part B covers pressure-reducing support surfaces as durable medical equipment (DME) that your doctor prescribes for use in your home.
If you live in certain states, you may have to get prior approval for 5 types of pressure-reducing support surfaces.
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Medicare Part B (Medical Insurance) covers a blood-based biomarker lab test to screen for colorectal cancer if you meet all of these conditions:You’re between 45–85.You show no symptoms of colorectal disease (including, but not limited to, lower gastrointestinal pain, blood in stool, or positive…
Medicare Part B (Medical Insurance) covers FDA-authorized COVID-19 antibody tests...
Medicare Part B (Medical Insurance) covers disease-specific services to help manage your care for a single, complex chronic condition that puts you at risk of hospitalization, physical or cognitive decline, or death. If you have 1 chronic high-risk condition that you expect to last at…
Medicare Part B (Medical Insurance) covers caregiver training services for caregivers involved in the treatment of Medicare patients if both of these conditions apply:The training focuses on helping the patient meet the health and treatment goals they set with their doctor or other health…
Medicare Part B (Medical Insurance) may cover FDA-approved monoclonal antibodies that target beta-amyloid plaques for the treatment of Alzheimer’s disease if you meet certain criteria. Your doctor or other health care provider must confirm you have beta-amyloid plaques consistent with Alzheimer’s…
Medicare Part B (Medical Insurance) covers principal illness navigation services if you have a serious condition that’s expected to last at least 3 months (like cancer, HIV, or substance use disorder) and puts you at a high risk for one or more of the following:HospitalizationNursing home…
Social determinants of health are non-medical factors that can impact your health and quality of life, like your:Living environmentAccess to foodEmployment statusEducation and literacy levelsFamily circumstancesMedicare Part B (Medical Insurance) covers this risk assessment when your doctor or…
Home health services like intermittent skilled nursing care, physical therapy, speech-language pathology, continued occupational services...
Explanation of Medicare Part A coverage of certain skilled care services that are needed daily within an SNF for up to 100 days...
Under certain conditions, Medicare covers transplants that aren’t organ transplants. Under certain conditions, Part A (Hospital Insurance) covers: Stem cell transplants Necessary tests, labs, and exams associated with the transplant Under certain conditions, Part…
RSV is a respiratory virus that causes cold-like symptoms. People who are 65 and older are at high risk of having serious health complications from RSV. Getting the RSV shot can protect you from getting RSV.Medicare drug coverage (Part D) covers the RSV shot (not Part A (Hospital Insurance) or Part…
Starting January 1, 2024, Medicare Part B (Medical Insurance) covers gradient compression garments (standard and custom-fitted) if you've been diagnosed with lymphedema and your doctor or other health care provider prescribes them...
Starting January 1, 2024, Medicare Part B (Medical Insurance) covers intensive outpatient program services you get at a hospital, community mental health center, Federally Qualified Heath Center, or Rural Health Clinic...
Part B covers a diabetes prevention program once if you meet certain conditions...
Medicare may cover cataract surgery that implants conventional intraocular lenses, depending on where you live. Medicare doesn’t usually cover eyeglasses or contact lenses. However, Medicare Part B (Medical Insurance) covers one pair of eyeglasses with standard…
Part B covers monthly services for people living with chronic pain (persistent or recurring pain lasting longer than 3 months). Services may include pain assessment, medication management, and care coordination and planning...
Medicare may pay for inpatient hospital, doctor or ambulance services you get when you travel outside the U.S. in rare cases...
If your doctor or other health care provider gives you a social determinants of health risk assessment, they may find that social factors (like limited access to food or your living environment) are impacting your health or access to care. In these cases, Medicare Part B (Medical Insurance) covers…
Part B covers outpatient mental health services at a doctor or other health care provider's office or hospital outpatient department...
Medicare Part B covers partial hospitalization services furnished by a hospital to its outpatients or by a community mental health center...
Medicare Part A covers mental health care services you get in a hospital that require you to be admitted as an inpatient...
Medicare covers the updated (2023–2024 formula) Moderna or Pfizer-BioNTech COVID-19 vaccine for people 5 and older.If you’re 65 or older and/or immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases), you can get a 3-dose series of updated…
Medicare Part B (Medical Insurance) covers urgently needed care to treat a sudden illness or injury that isn't a medical emergency...
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- Use this list if you’re a person with Medicare, family member or caregiver. Medicare coverage for many tests, items and services depends on where you live. This list only includes tests, items and services (both covered and non-covered) if coverage is the same no matter where you live.
- If your test, item or service isn’t listed, talk to your doctor or other health care provider about why you need certain tests, items or services. Ask if Medicare will cover them.
- Use this list if you’re a Medicare contractor, provider or other health care industry professional. This list includes the ability to search by procedure codes (CPT/HCPCS codes).