Medicare questions and answers

In 2026, most people pay nothing for Medicare Part A and the standard $202.90 a month for Medicare Part B, which has a $283 yearly deductible.

CMS has not announced the 2027 Medicare Part B premium yet; it usually publishes the next year's Part B premium and deductible in the fall, often in November.

IRMAA, the income-related monthly adjustment amount, is an extra charge added to the Medicare Part B and Part D premiums of people with higher incomes.

The Medicare Part D out-of-pocket limit is $2,400 in 2027, up from $2,100 in 2026: once your out-of-pocket spending on covered Part D drugs reaches the limit, you pay nothing for covered Part D drugs for the rest of the calendar year.

For 2027, CMS caps the yearly out-of-pocket limit a Medicare Advantage plan can set at $9,850 for in-network services and $14,800 for in-network and out-of-network services combined, up from $9,250 and $13,900 in 2026.

Medicare charges a late enrollment penalty if you don't sign up for Part B or Part D when you're first eligible and you don't have other qualifying coverage, and the penalty generally lasts as long as you have that coverage.

The Medicare Prescription Payment Plan is a free payment option, offered by all Medicare drug plans and Medicare health plans with drug coverage, that spreads your Part D out-of-pocket drug costs across the calendar year in monthly bills from your plan instead of payments at the pharmacy.

In 2027, Medicare Part D out-of-pocket costs for covered drugs are capped at $2,400, up from $2,100 in 2026, and no Medicare drug plan may have a deductible above $700 ($615 in 2026).

Most people should sign up for Medicare during their Initial Enrollment Period, the 7 months that start 3 months before the month they turn 65 and end 3 months after it.

You sign up for Medicare Part A and Part B through Social Security, online at ssa.gov, by phone or at a local Social Security office; railroad workers sign up through the Railroad Retirement Board.

Medicare's main enrollment windows are the 7-month Initial Enrollment Period around your 65th birthday and the General Enrollment Period, January 1 to March 31, for people who missed it.

Not always: if you or your spouse are actively working and covered by that employer's group health plan, you can usually delay Medicare Part B without a penalty and sign up within 8 months after the job or the coverage ends.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 each year, and only people already in a Medicare Advantage plan (Part C) can use it, to make one change.

Medicare coverage starts on the first day of a month that depends on when you sign up: if you sign up during the 3 months before the month you turn 65, Medicare Part A and Part B generally start the month you turn 65 (the month before, if your birthday is on the 1st).

Medicare has four parts: Part A is hospital insurance and Part B is medical insurance, and together they make up Original Medicare, run by the federal government.

Yes, Medicare covers prescription drugs through Part D: you get it by joining a stand-alone Part D drug plan alongside Original Medicare, or a Medicare Advantage plan that includes drug coverage.

Medicare's negotiated prices took effect January 1, 2026 for the first 10 Part D drugs, including Eliquis, Jardiance, Xarelto, Januvia, Farxiga and NovoLog and Fiasp insulin.

Original Medicare doesn't cover most dental care, routine eye exams for glasses, hearing aids, long-term custodial care, most care outside the U.S., cosmetic surgery or routine foot care.

Original Medicare doesn't cover routine dental care such as cleanings, fillings, extractions and dentures, routine eye exams for glasses or contacts, or hearing aids and the exams to fit them.

Medicare doesn't pay for long-term custodial care in a nursing home, such as help with bathing, dressing and eating, when that is the only care you need.

Medigap Plan G and Plan N both pay the Medicare Part A deductible, hospital and skilled nursing coinsurance, and 80% of foreign travel emergency care, and neither pays the Part B deductible ($283 in 2026).

Original Medicare usually doesn't cover health care outside the U.S., with a few exceptions, such as some emergencies when a foreign hospital is closer than the nearest U.S. hospital, and certain care on a cruise ship in or within 6 hours of a U.S. port.

At a Medicare annual wellness visit, which Medicare Part B covers once every 12 months, your doctor or other health care provider asks you to fill out a Health Risk Assessment questionnaire, reviews your medical and family history and prescriptions, takes routine measurements, checks for signs of dementia and gives you a written prevention plan.

Medicare Part B covers a long list of preventive services, including screenings, lab tests, vaccines, counseling, health monitoring programs and two preventive visits, and you pay nothing for most of them if your provider accepts assignment.

Yes, Medicare Part B covers a one-time abdominal aortic aneurysm screening ultrasound if you're at risk because you have a family history of abdominal aortic aneurysms, or you're a man between 65 and 75 who has smoked at least 100 cigarettes in your lifetime.

Medicare Part B covers acupuncture, including dry needling, only for chronic low back pain: pain that has lasted 12 weeks or longer, has no known cause, and isn't associated with surgery or pregnancy.

Yes, Medicare covers treatment for substance use disorders: Part A covers inpatient hospital care, Part B covers outpatient counseling, therapy, intensive outpatient programs and Opioid Treatment Program services, and Part D may cover medications like buprenorphine and naltrexone.

No, Original Medicare (Part A and Part B) doesn't cover incontinence supplies or adult diapers, so you pay 100% of the cost of those items yourself.

Yes, Medicare Part B covers voluntary advance care planning as part of your “Welcome to Medicare” preventive visit and yearly “Wellness” visits, and Medicare may also cover it as part of your medical treatment.

Yes, Medicare Part B may cover FDA-approved monoclonal antibodies for early Alzheimer's disease, like Leqembi (lecanemab) and Kisunla (donanemab), if your provider confirms beta-amyloid plaques and diagnoses mild cognitive impairment or mild dementia due to Alzheimer's disease.

Yes, Medicare Part B covers ground ambulance transportation to a hospital, critical access hospital, rural emergency hospital or skilled nursing facility when traveling in any other vehicle could endanger your health and you need medically necessary services there.

Original Medicare (Part A and Part B) doesn't cover a routine physical exam, so you may have to pay the full amount for a routine physical yourself.

No, Original Medicare doesn't pay for the non-medical long-term care people get in an assisted living facility, like help with dressing, bathing and using the bathroom, and you pay all costs for that care unless other coverage helps.

Yes: Medicare Part B covers some bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery, if you meet certain conditions related to morbid obesity.

Yes, Medicare covers blood transfusions: Medicare Part A covers blood you get as a hospital inpatient, and Medicare Part B covers blood you get as a hospital outpatient.

Yes, Medicare Part B covers medically necessary diagnostic laboratory tests, including certain blood tests, urinalysis and certain tests on tissue specimens, when your health care provider orders them.

Yes, Medicare Part B covers bone density tests, which Medicare calls bone mass measurements, once every 24 months (or more often if medically necessary) if you meet at least one of the conditions Medicare lists, like being a woman whose doctor determines you're estrogen-deficient and at risk for osteoporosis.

Yes, Medicare Part B covers regular and intensive cardiac rehabilitation programs, which include exercise, education and counseling, if you have a qualifying heart condition.

Yes, Medicare Part B covers caregiver training when a health care provider determines the training is appropriate for the patient's treatment plan, and the caregiver can get individual or group sessions without the patient present.

Yes: Medicare Part B may cover cataract surgery that implants conventional intraocular lenses, depending on where you live.

Yes, Medicare covers chemotherapy if you have cancer: Medicare Part A covers it when you're a hospital inpatient, and Medicare Part B covers it in a hospital outpatient setting, a doctor's office or a freestanding clinic.

Medicare Part B covers only one chiropractic service: adjustments of the spine by a chiropractor to correct a subluxation, when the chiropractor uses their hands or a device called an activator.

Yes, Medicare Part B covers cardiovascular disease screening blood tests for cholesterol, lipid and triglyceride levels once every 5 years, to help detect conditions that may lead to a heart attack or stroke.

Yes, Medicare Part B may pay for a doctor or other health care provider to help manage your care each month if you have 2 or more serious chronic conditions, like arthritis and diabetes, that you expect to last at least a year.

Medicare covers some costs in certain clinical research studies: Medicare Part A and/or Part B cover routine costs, like office visits and tests, in qualifying clinical trials, along with care for complications from taking part.

Yes, Medicare covers cochlear implants as prosthetic devices for people who meet CMS's coverage criteria, and Medicare Part A or Part B pays depending on whether the implant surgery takes place in an inpatient or outpatient setting.

Yes, Medicare Part B covers Cologuard, a multitarget stool DNA test, as an at-home screening every 3 years if you're 45 to 85, have no symptoms of colorectal disease and are at average risk for colorectal cancer.

Yes, Medicare Part B covers screening colonoscopies, with no minimum age requirement, once every 24 months if you're at high risk for colorectal cancer and once every 120 months (or 48 months after a previous flexible sigmoidoscopy) if you aren't.

Medicare Part B covers gradient compression garments, like compression stockings, only if you have lymphedema and your doctor or other health care provider orders them, under a benefit that started January 1, 2024.

Original Medicare (Part A and Part B) doesn't cover the membership fee for concierge care, also called concierge medicine, so you pay that fee yourself.

Yes, Medicare Part B covers a continuous glucose monitor and related supplies, like sensors, as durable medical equipment if you have diabetes, your doctor orders them and you meet Medicare's conditions.

Original Medicare (Part A and Part B) usually doesn't cover cosmetic surgery, so you usually pay all costs for surgery done to change how you look.

Yes, Medicare Part B (Medical Insurance) covers FDA-approved and FDA-authorized COVID-19 vaccines, including the updated COVID-19 vaccines Medicare.gov lists, for anyone who has Medicare.

Yes, Medicare Part B covers a 12-week trial of CPAP (continuous positive airway pressure) therapy, including the machine and accessories, as durable medical equipment if you've been diagnosed with obstructive sleep apnea.

Yes, Medicare Part B covers crutches as durable medical equipment (DME) when they're medically necessary and your provider prescribes them for use in your home.

Yes, Medicare may cover an implantable cardioverter defibrillator (ICD) if you're eligible: Medicare Part A covers the surgery to implant it in a hospital inpatient setting, and Medicare Part B covers the surgery in a hospital outpatient setting.

Medicare covers some dementia care: Medicare Part B covers a separate visit to fully review your cognitive function, establish or confirm a diagnosis like dementia or Alzheimer's disease, and develop a care plan.

Original Medicare (Part A and Part B) doesn't cover most dental care, like routine cleanings, fillings, tooth extractions, dentures or implants, so in most cases you pay all costs for dental care yourself.

Original Medicare (Part A and Part B) doesn't cover dental implants in most cases, so you usually pay all costs for implants yourself.

Original Medicare (Part A and Part B) doesn't cover dentures in most cases, so you usually pay all costs for dentures yourself.

Yes, Medicare Part B covers one depression screening a year, which you must get in a primary care setting, like a doctor's office, where you can get follow-up treatment and referrals to a mental health provider.

Yes, Medicare Part B covers the Medicare Diabetes Prevention Program, a health behavior change program to help you prevent type 2 diabetes, if you're at risk and meet its blood test and body mass index requirements.

Yes, Medicare Part B covers diabetes screenings, up to 2 each year, if your doctor or other health care provider determines you're at risk for developing diabetes.

Yes, Medicare Part B covers therapeutic shoes and inserts if you have diabetes and severe diabetes-related foot disease, and the doctor who treats your diabetes certifies that you need them.

Yes, Medicare Part B covers blood sugar (glucose) test strips as supplies for a home blood sugar monitor, along with lancets, lancet holders and control solutions, when your doctor prescribes them.

Yes, Medicare covers dialysis if you have End-Stage Renal Disease (ESRD): Medicare Part A covers inpatient dialysis in a hospital, and Medicare Part B covers outpatient dialysis in a Medicare-certified facility or at home, plus home dialysis training, equipment and supplies.

No, Original Medicare doesn't pay for custodial or personal care, like help with bathing, dressing or using the bathroom, when that is the only care someone needs, and Medicare home health care must come from a Medicare-certified home health agency.

Yes, Medicare Part B covers medically necessary durable medical equipment (DME) when your doctor or other health care provider orders it for use in your home.

Yes, Medicare Part B covers EKGs (also called ECGs) as diagnostic tests when they're medically necessary, and covers one routine EKG screening if your provider refers you for it during your one-time “Welcome to Medicare” preventive visit.

Yes, Medicare drug coverage (Part D) covers Eliquis: CMS says Medicare drug plans, including standalone Part D plans and Medicare Advantage plans with drug coverage, must include drugs with a Medicare negotiated price, like Eliquis, on their drug lists (formularies).

Yes, Medicare Part B usually covers emergency department services, which are the services you get in a hospital emergency department for an injury, a sudden illness, or an illness that quickly gets much worse.

No, Medicare drug coverage (Part D) doesn't cover drugs when they're used to treat sexual or erectile dysfunction (ED), because CMS rules exclude them from Part D coverage.

Medicare Part B covers some eye exams and tests for specific medical conditions, like diabetes or a high risk of glaucoma, but Original Medicare doesn't cover routine eye exams (eye refractions) for eyeglasses or contact lenses.

Yes, Medicare Part B (Medical Insurance) covers the seasonal flu vaccine as a preventive service, usually one flu shot each flu season.

Sometimes: Medicare Part B covers medically necessary diagnostic lab tests that your provider orders, and Medicare's national coverage rule for next generation sequencing (NGS) genetic tests covers them for people with certain cancers who meet CMS's conditions.

Yes, Medicare Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens.

Original Medicare (Part A and Part B) doesn't usually cover eyeglasses or contact lenses and doesn't cover routine eye exams for glasses or contacts, so you usually pay all costs for them.

Yes, Medicare Part B covers a glaucoma screening once every 12 months if you're at high risk for glaucoma because you have diabetes, have a family history of glaucoma, are African American and 50 or older, or are Hispanic and 65 or older.

Original Medicare (Part A and Part B) doesn't cover gym memberships or fitness programs, so you pay all costs for them yourself.

Original Medicare (Part A and Part B) doesn't cover hearing aids or the exams to fit them, so you pay the full cost of hearing aids yourself.

Yes, Medicare Part B covers diagnostic hearing and balance exams when your doctor or other health care provider orders them to find out if you need medical treatment.

Yes, Medicare Part B covers counseling to help you stop smoking or using tobacco, with up to 8 counseling sessions in a 12-month period.

Yes, Medicare Part B (Medical Insurance) covers hepatitis B vaccines if you meet at least one of Medicare's conditions, such as never having gotten a complete series of hepatitis B vaccines.

Yes, Medicare Part B covers a hepatitis C virus infection screening if your primary care doctor or other health care provider orders it and you use or have used illicit injection drugs, had a blood transfusion before 1992, or were born between 1945 and 1965.

Yes, Medicare covers medically necessary hip replacement surgery: Medicare Part A covers your hospital stay if you're formally admitted as an inpatient, and Medicare Part B covers hospital outpatient services if you have the surgery as an outpatient.

Yes, Medicare Part B covers pre-exposure prophylaxis (PrEP) for HIV prevention as a preventive service if you don't have HIV and your doctor or other health care provider determines you're at increased risk for HIV.

Yes, Medicare Part A and Part B cover part-time or intermittent home health care, like skilled nursing care and physical therapy, when you're homebound, a doctor or other provider orders the care, and a Medicare-certified home health agency provides it.

Yes, Medicare Part B covers home infusion therapy, including the pumps, IV poles, tubing and catheters used at home and services like nursing visits, caregiver training and patient monitoring needed to give certain drugs safely.

Yes, Medicare Part B covers oxygen and oxygen equipment for use in your home if your doctor says you aren't getting enough oxygen, your health might improve with oxygen therapy, and your arterial blood gas level falls within a certain range.

Yes, Medicare Part A covers hospice care if your hospice doctor and your regular doctor (if you have one) certify that you're terminally ill with a life expectancy of 6 months or less and you choose comfort care instead of care to cure your illness.

Yes, Medicare Part B may cover a hospital bed for use in your home as durable medical equipment when it's medically necessary and your provider prescribes it.

Yes, for certain conditions: Medicare Part B may cover hyperbaric oxygen therapy given in a chamber if you have one of the conditions Medicare lists, such as acute carbon monoxide intoxication, decompression illness or certain diabetic wounds of the lower extremities.

Medicare Part A and Part B pay for part-time or intermittent home health aide care only when you're homebound, need part-time or intermittent skilled care, and are also getting skilled nursing care, physical therapy, speech-language pathology services or occupational therapy from a Medicare-certified home health agency.

Yes, Medicare Part A covers mental health care you get when you're admitted as a hospital inpatient, in a general hospital or a psychiatric hospital, and Medicare Part B covers the services you get from doctors and other providers while you're in the hospital.

Yes, Medicare Part A covers medically necessary care in an inpatient rehabilitation facility or unit, and Medicare Part B covers the doctors' services you get while you're there.

Yes, Medicare covers insulin: Part B covers insulin used with an insulin pump that's covered as durable medical equipment, and a Medicare drug plan (Part D) may cover injectable insulin, inhaled insulin and insulin used with pumps that Part B doesn't cover.

Yes, Medicare covers medically necessary knee replacement surgery: Medicare Part A covers your hospital stay if you're formally admitted as an inpatient, and Medicare Part B covers the surgery if you have it as a hospital outpatient.

Yes, Medicare Part B covers arm, leg, back and neck braces when they're medically necessary and a doctor or other health care provider orders them.

Medicare Part B may cover the seat lift mechanism of a lift chair as durable medical equipment, but not the chair itself, for people with severe arthritis of the hip or knee or a severe neuromuscular disease who meet all of Medicare's conditions.

Yes, Medicare Part B covers lung cancer screening with low-dose computed tomography (a CT scan) once a year if you're 50 to 77, have no signs or symptoms of lung cancer, are a current smoker or quit smoking within the last 15 years, have a tobacco smoking history of at least 20 pack-years, and get an order from your provider.

Yes, Medicare Part B covers a screening mammogram once every 12 months for women 40 and older, one baseline mammogram for women 35 to 39, and diagnostic mammograms when they're medically necessary.

Original Medicare (Part A and Part B) doesn't cover massage therapy, so you pay all costs for massage therapy yourself.

Yes, Medicare Part B covers diagnostic non-laboratory tests such as MRIs, CT scans, X-rays, PET scans and EKGs when your doctor or other health care provider orders them to find or treat a medical problem.

Yes, Medicare Part B covers nebulizers and some nebulizer medications (if reasonable and necessary) as durable medical equipment (DME), according to Medicare.gov's DME booklet.

Yes, Medicare Part B covers medical nutrition therapy, including nutrition counseling from a registered dietitian, if you have diabetes or kidney disease, or you've had a kidney transplant in the last 36 months, and a doctor refers you.

Yes: Medicare Part B covers obesity screening and behavioral counseling if you have a body mass index (BMI) of 30 or more, and you pay nothing when your primary care provider accepts assignment.

Yes, Medicare Part B covers observation services, which are hospital outpatient services you get while your doctor decides whether to admit you as an inpatient or discharge you.

Yes, Medicare Part B covers medically necessary outpatient occupational therapy when your doctor or other health care provider certifies that you need it.

Yes, Medicare covers oral cancer drugs: Medicare Part B covers some cancer drugs you take by mouth if the same drug is available in an injectable form or is a prodrug of the injectable drug, and Medicare drug coverage (Part D) covers many drugs Part B doesn't.

Yes, Medicare covers heart, lung, kidney, pancreas, intestine and liver transplants: Medicare Part A generally covers the transplant services and the cost of finding the organ, and Medicare Part B covers the doctors' services.

Medicare Part B covers orthopedic shoes only if they're a necessary part of a leg brace.

Sometimes: Medicare Part A and Part B cover certain injectable osteoporosis drugs, and home health nurse visits to give the injections, for women who qualify for Medicare home health services, have a fracture related to postmenopausal osteoporosis, and can't give themselves the injection, with no family member or caregiver able or willing to.

Yes, Medicare Part B covers medically necessary ostomy supplies under the prosthetic device benefit if you've had a colostomy, ileostomy or urinary ostomy.

Yes, Medicare Part B covers approved outpatient services and supplies, including outpatient surgeries, and Part B covers the facility fees for approved surgical procedures you get in an ambulatory surgical center.

No, Medicare drug coverage (Part D) doesn't cover over-the-counter (nonprescription) drugs, except insulin and supplies associated with injecting insulin, because CMS rules leave over-the-counter products out of the definition of a Part D drug.

Sometimes: Medicare drug coverage (Part D) might cover Ozempic, a semaglutide injection the FDA has approved to improve blood sugar control in adults with type 2 diabetes, depending on your Medicare drug plan's list of covered drugs (formulary).

Yes: Medicare Part B covers most pain management services, including chronic pain management and treatment services, physical therapy and occupational therapy.

Yes, Medicare Part B covers Pap tests and pelvic exams to check for cervical and vaginal cancer once every 24 months in most cases, and once every 12 months if you're at high risk or you're of child-bearing age and had an abnormal Pap test in the past 36 months.

Yes, Medicare Part B covers medically necessary outpatient physical therapy when your doctor or other health care provider certifies that you need it.

Yes, Medicare Part B (Medical Insurance) covers pneumococcal vaccines, which protect against different strains of the bacteria that cause pneumonia.

Medicare Part B covers podiatrist (foot doctor) exams and treatment when you need medically necessary care for foot injuries or diseases, like hammer toe, bunion deformities and heel spurs, but Medicare doesn't usually cover routine foot care such as trimming nails or removing corns and calluses.

Yes, Medicare Part B covers prostate cancer screening, a digital rectal exam and a prostate-specific antigen (PSA) blood test, once every 12 months for men over 50, starting the day after the 50th birthday.

Yes, Medicare Part B covers prosthetic devices, including artificial arms, legs and eyes, when they're medically necessary and a doctor or other health care provider orders them.

Yes, Medicare Part B covers a comprehensive pulmonary rehabilitation program if you have moderate to very severe chronic obstructive pulmonary disease (COPD).

Yes, Medicare covers radiation therapy: Medicare Part A covers it for hospital inpatients, and Medicare Part B covers it for outpatients and for patients in freestanding clinics.

Yes, Medicare Part A covers short-term skilled nursing and therapy in a Medicare-certified skilled nursing facility (SNF) after a qualifying inpatient hospital stay of at least 3 days in a row, when your doctor decides you need daily skilled care.

Medicare Part A covers respite care as part of the hospice benefit: if you get hospice care, your hospice provider can arrange inpatient respite care in a Medicare-approved facility for up to 5 days each time, more than once but only on an occasional basis, so your usual caregiver can rest.

Original Medicare generally doesn't pay for rides to doctor appointments, but Medicare Part B covers ground ambulance transportation when traveling in any other vehicle could endanger your health and you need medically necessary services from a hospital, critical access hospital, rural emergency hospital or skilled nursing facility.

Yes, Medicare drug coverage (Part D) covers the RSV (respiratory syncytial virus) vaccine, and you pay nothing for the RSV vaccine if you have Part D.

Yes, in some cases Medicare Part B covers a second opinion for medically necessary, non-emergency surgery, when another doctor gives their view about your health problem and how it should be treated.

Yes, Medicare drug coverage (Part D) covers the shingles vaccine, and you pay nothing for the shingles vaccine if you have Part D.

Original Medicare (Part A and Part B) doesn't name shower chairs as covered equipment and doesn't cover most bathroom safety items: CMS's durable medical equipment reference list denies bathtub seats, bathtub lifts, grab bars and raised toilet seats because they aren't primarily medical in nature.

Yes, Medicare Part B covers Type I, II, III and IV sleep tests and devices if you have clinical signs and symptoms of sleep apnea and your doctor or other health care provider orders the test.

Yes, Medicare Part B covers medically necessary outpatient speech therapy, which Medicare calls speech-language pathology services, when your doctor or other health care provider certifies that you need it.

No, Original Medicare (Part A and Part B) doesn't cover stair lifts: CMS's durable medical equipment reference list denies stairway elevators as convenience items that aren't primarily medical in nature.

Yes, Medicare Part B covers screenings for chlamydia, gonorrhea, syphilis and hepatitis B if you're pregnant or at increased risk for a sexually transmitted infection (STI), once every 12 months or at certain times during pregnancy.

Yes, Medicare drug coverage (Part D) covers the Tdap vaccine, and you pay nothing for the Tdap vaccine if you have Part D.

Yes, Medicare Part B covers certain telehealth services, like office visits, psychotherapy and consultations, that you get from a provider located somewhere else in the U.S. using audio and video technology (or audio-only communication in some cases).

Medicare Part B covers a TENS (transcutaneous electrical nerve stimulation) unit as durable medical equipment only in limited cases: for acute pain after surgery, or for chronic, intractable pain other than chronic low back pain when Medicare's conditions are met.

Yes, Medicare Part B covers outpatient mental health therapy and counseling, including individual and group psychotherapy, and family counseling when its main purpose is to help with your treatment.

Yes, Medicare Part B covers urgently needed care, which treats a sudden illness or injury that isn't a medical emergency or life-threatening.

Only in limited cases: Medicare drug coverage (Part D) excludes prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations, and CMS says over-the-counter products aren't Part D drugs.

Yes, Medicare Part B covers walkers, including rollators, and canes as durable medical equipment when they're medically necessary and your provider prescribes them for use in your home.

Yes, in some cases: starting July 1, 2026, Medicare covers the GLP-1 drugs Wegovy, Zepbound (KwikPen only) and Foundayo through the temporary Medicare GLP-1 Bridge program, if you have Medicare drug coverage (Part D) and meet its age, body mass index (BMI) and health requirements.

Yes, Medicare Part B covers manual wheelchairs, power wheelchairs and power-operated vehicles (scooters) as durable medical equipment when they're medically necessary and prescribed for use in your home.

Yes, Medicare Part B covers medically necessary treatment of a surgical or surgically treated wound, and under the local coverage policy that Medicare's durable medical equipment contractors use, surgical dressings are covered for a qualifying wound: one caused by or treated by a surgical procedure, or one that has been debrided.

Original Medicare (Parts A and B) is run by the federal government and lets you see any doctor or hospital in the U.S. that accepts Medicare, but it has no yearly out-of-pocket limit, so many people add a Medigap policy and a Part D drug plan.

Start by deciding between Original Medicare, usually with a Part D drug plan and often a Medigap policy, and a Medicare Advantage plan, then compare the plans offered in your ZIP code.

You can change Medicare Advantage and Part D plans during the Annual Enrollment Period, October 15 to December 7, for coverage that starts January 1.

Yes, you can leave Medicare Advantage for Original Medicare during the Annual Enrollment Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31).

If your Medicare Advantage plan won't be offered in your area for 2027, the plan must tell you in writing, and you can choose new coverage during Annual Enrollment (October 15 to December 7, 2026) or in a Special Enrollment Period that runs through the end of February 2027.

High-deductible Medigap Plan G is a version of Medigap Plan G, sold in some states, where you pay up to $2,950 in 2026 for Medicare-covered costs before the Medigap policy pays anything.

Some Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, like vision, hearing and dental care or certain gym memberships or discounts, and some may also cover rides to doctor visits and over-the-counter drugs that Medicare Part D doesn't cover.

A Medicare Advantage HMO generally covers care only from doctors, other providers and hospitals in the plan's network, except emergency care, out-of-area urgent care and temporary out-of-area dialysis, while a Medicare Advantage PPO also covers out-of-network providers, usually at a higher cost.

Yes, Medicare Advantage plans can require prior authorization, meaning approval from the plan before it covers certain services, supplies or drugs, while Original Medicare in most cases doesn't require approval in advance.

Medicare itself doesn't issue flex cards, and CMS warns that if a caller offers a flex card from Medicare, it's a scam.

What ads call a Medicare "Part B giveback" is what Medicare.gov calls a "Medicare Part B premium reduction": some Medicare Advantage plans will help pay all or part of your Part B premium.

A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage plan (Part C) for people with specific severe or disabling chronic conditions, people who need the level of care a facility offers, or people who have both Medicare and Medicaid.

Medigap Plan F and Plan G cover the same Original Medicare costs except one: Medigap Plan F pays the Medicare Part B deductible ($283 in 2026) and Medigap Plan G doesn't.

Yes, with Original Medicare (Part A and Part B) you can go to any doctor or hospital that takes Medicare, anywhere in the U.S., which for Medicare includes the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa.

To appeal a denial in Original Medicare (Part A and Part B), you file a first-level appeal, called a redetermination, with the Medicare Administrative Contractor by the date shown on your Medicare Summary Notice (MSN).

You can replace a lost or damaged Medicare card by logging into (or creating) your secure Medicare.gov account and printing or ordering an official copy, and Medicare's card replacement options are free.

No: once you're enrolled in Medicare, including premium-free Part A on its own, you can't contribute to a Health Savings Account (HSA), because the IRS sets your HSA contribution limit at zero beginning with the first month you're enrolled in Medicare.

No, you don't have to claim Social Security benefits to get Medicare: if you want Medicare Part A and Part B at 65 but aren't taking retirement benefits yet, you sign up for Medicare through Social Security without applying for benefits.

Medicare works with TRICARE For Life, the coverage for Medicare-eligible uniformed services retirees 65 or older and their eligible family members, and you must have both Medicare Part A and Part B to get TRICARE For Life benefits.

Medicare and VA health care generally can't pay for the same items or services: Medicare pays for Medicare-covered care, the VA pays for VA-authorized care at VA or non-VA facilities, and you choose which benefit to use each time you get care.

Your younger spouse can't be covered by your Medicare, because Medicare doesn't offer plans for couples or families; your spouse can get Medicare when they're first eligible, usually at 65.

Medicare doesn't call you uninvited to ask for your Medicare Number or other personal information, and Medicare never calls to sell you anything or visits you at your home.

If you're under 65 and get Social Security disability benefits, or certain disability benefits from the Railroad Retirement Board, you get Medicare Part A and Part B automatically after 24 months of those benefits.

Medicare covers people of any age with End-Stage Renal Disease (ESRD), permanent kidney failure that needs regular dialysis or a kidney transplant, if they have enough work under Social Security, the Railroad Retirement Board or as a government employee, get or are eligible for those benefits, or are the spouse or dependent child of someone who does.

With Original Medicare (Part A and Part B), a move to another state doesn't change where you can get care, because you can go to any doctor or hospital that takes Medicare anywhere in the U.S.

A Medicare Summary Notice (MSN) isn't a bill: it's a notice people with Original Medicare get in the mail at least twice a year that lists the Medicare Part A and Part B services and supplies billed to Medicare, what Medicare paid and the maximum amount you may owe the provider.

An Advance Beneficiary Notice of Non-coverage (ABN) is a written notice your doctor, other health care provider or supplier may give you in Original Medicare when they think Medicare won't pay for an item or service, listing the items, an estimate of their costs and the reasons Medicare may not pay.

You're eligible for Medicare at 65 if you're a U.S. citizen or have been a lawful permanent resident for at least 5 years in a row.

Medicare is federal health insurance for people 65 and older and some younger people with disabilities, ALS or End-Stage Renal Disease, and it isn't based on income.

If your income and savings are limited, your state's Medicare Savings Programs can pay your Part B premium, and the Qualified Medicare Beneficiary (QMB) program also pays Medicare deductibles, coinsurance and copays.

Generally, no: Medicare is health insurance for people 65 or older, though you may be eligible for Medicare before 65 if you have a disability, End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig's disease).

Yes, people who have both Medicare and full-benefit Medicaid coverage are called dual eligible, and Medicare pays first for Medicare-covered services while Medicaid pays last, after Medicare and any other health insurance.

This Medicare glossary defines 67 Medicare terms in plain English, from Part A and Part B basics like the benefit period, deductible and coinsurance to Medicare Advantage, Medigap and Part D drug coverage rules.