What Does Medicare Cover? An A–Z Guide to Common Services
What does Medicare cover? Original Medicare helps pay for medically necessary hospital and medical care and many preventive services. Part A covers hospital care, Part B covers doctor and outpatient care, and Part D covers most prescriptions.
What does Medicare cover? Original Medicare helps pay for care you need to diagnose or treat a health problem. It also pays for many screenings and shots that help prevent illness or find it early. Part A covers hospital care. Part B covers doctor visits, outpatient care (care when you aren't admitted to a hospital as an inpatient), and medical equipment. Part D covers most drugs you fill at a pharmacy.
This guide has an A–Z table of common services, which part covers each one and what you usually pay in 2026. After it, you'll find the services people ask about most and how to check anything that isn't listed.
What does Medicare cover in general?
Medicare.gov describes two kinds of care that Part B helps pay for:
- Medically necessary services. Services or supplies that meet accepted standards of medical practice to diagnose or treat your condition.
- Preventive services. Care to prevent illness or find it early.
You pay nothing for most preventive care if your provider accepts assignment. That means the provider accepts the amount Medicare allows as payment in full. For most other Part B care, you pay the $283 deductible in 2026. After that, you usually pay 20%. Original Medicare has no yearly cap on what you pay. Our Medicare cost guide explains every cost.
What does Medicare cover? An A–Z table
The table is for Original Medicare and Medicare drug coverage (Part D) in 2026, with a provider who accepts assignment. Costs are not the same in a Medicare Advantage plan or with other coverage.
Services from A to F
| Service | Which part | What you usually pay |
|---|---|---|
| Ambulance (ground) | Part B | 20% after the deductible |
| Cancer treatment (chemotherapy) | Part A as a hospital inpatient; Part B as an outpatient or in a doctor's office | Part B: 20% after the deductible |
| Chiropractic care | Part B, spine adjustments only | 20% after the deductible |
| Colonoscopy (screening) | Part B | $0; 15% if a polyp is removed |
| COVID-19 vaccine | Part B | $0 |
| Dental care (routine) | Not covered in most cases | All costs |
| Durable medical equipment | Part B | 20% after the deductible |
| Emergency room | Part B | A copayment for each visit and each hospital service, plus 20% for doctor services after the deductible |
| Eye exams for glasses | Not covered | All costs |
| Flu shot | Part B | $0 |
| Hearing aids | Not covered | All costs |
Services from H to Y
| Service | Which part | What you usually pay |
|---|---|---|
| Hospice care | Part A | $0 for covered services; up to $5 per prescription for pain and symptom drugs |
| Hospital stay (inpatient) | Part A | $1,736 deductible per benefit period |
| Long-term custodial care | Not covered | All costs |
| Mental health care (outpatient) | Part B | 20% after the deductible; yearly depression screening $0 |
| Occupational therapy | Part B | 20% after the deductible |
| Physical therapy | Part B | 20% after the deductible |
| Pneumococcal shot | Part B | $0 |
| Prescription drugs at the pharmacy | Part D | Varies by plan; $2,100 yearly cap in 2026 |
| Shingles shot | Part D | $0 if you have Part D |
| "Welcome to Medicare" visit | Part B | $0 |
| Yearly "Wellness" visit | Part B | $0 |
Figures are from Medicare.gov's coverage pages and the CMS fact sheet of November 14, 2025. Part D costs depend on your plan; see our article on the Part D out-of-pocket cap.
What is the Medicare annual wellness visit?
The Medicare annual wellness visit, which Medicare.gov calls the yearly "Wellness" visit, is covered once every 12 months. You pay nothing if your provider accepts assignment, and the Part B deductible doesn't apply. It is a talk with your provider to make or update a prevention plan. It is not a routine physical exam.
At the visit your provider will, among other things:
- take routine measurements, like height, weight and blood pressure
- review your medical and family history and your current prescriptions
- check for signs of memory problems, such as dementia
- give you a written plan of the screenings and shots you need
Your first yearly visit can't take place within 12 months of starting Part B or of your "Welcome to Medicare" visit. That one-time visit is covered within your first 12 months with Part B. If the provider adds tests or services during either visit, you may owe coinsurance and the Part B deductible for them, or the full cost if Medicare doesn't cover them (like a routine physical exam).
Does Medicare cover colonoscopy screening?
Yes. Part B covers screening colonoscopies, with no minimum age. How often depends on your risk:
- once every 24 months if you are at high risk for colorectal cancer
- otherwise once every 120 months, or 48 months after a previous flexible sigmoidoscopy
You pay nothing for the test if your provider accepts assignment. If the doctor finds and removes a polyp, you pay 15% coinsurance for the doctor's services. At a hospital outpatient department or a surgery center, you also pay 15% to the facility. The Part B deductible doesn't apply. Part B also covers a follow-up colonoscopy after a positive result from a Medicare-covered stool or blood-based screening test.
Does Medicare cover physical therapy?
Yes. Part B helps pay for physical therapy you get as an outpatient when your doctor or other provider certifies you need it. The same goes for occupational and speech therapy. After the deductible, you pay 20%. Medicare.gov says there's no limit on how much Medicare pays for this therapy in one year, as long as you need it.
Chiropractic care is much more limited. Part B only covers a chiropractor's adjustment of the spine, by hand or with a small device, to fix spinal joints that don't move the right way. This is called a subluxation. Medicare doesn't pay for X-rays, massage or other services a chiropractor orders.
Does Medicare cover emergency room visits?
Yes, Part B usually covers emergency room visits for an injury, a sudden illness or an illness that quickly gets worse. You pay a copayment for each visit and for each hospital service you get. After the deductible, you also pay 20% for your doctor's services. If your doctor admits you to the same hospital for a related condition within 3 days of your ER visit, you don't pay those copayments, because Medicare counts the visit as part of your inpatient stay.
Part B covers ground ambulance rides when any other vehicle could endanger your health. Medicare only pays to the nearest facility that can give the care you need. Medicare covers emergency care outside the U.S. only in rare cases.
What counts as Medicare durable medical equipment?
This is gear you can use again and again at home. Think of walkers, wheelchairs, hospital beds and home oxygen. Part B covers Medicare durable medical equipment when your doctor or other provider orders it for use at home. You pay 20% after the deductible.
A few rules matter:
- The supplier must be enrolled in Medicare, or Medicare won't pay.
- Ask whether the supplier accepts assignment. If not, you may pay more.
- Depending on the item, you may rent it, buy it, or choose.
What doesn't Original Medicare cover?
The Medicare & You 2027 handbook lists things it doesn't cover. They include:
- non-medical long-term care, like help with bathing and dressing
- eye exams for glasses or contact lenses
- hearing aids and exams for fitting them
- most dental care, such as cleanings, fillings and dentures
- routine physical exams, cosmetic surgery and massage therapy
- care from a provider who has opted out of Medicare, except in an emergency or urgent need
Some care tied to these areas is covered when you need it for a health problem. Read more in does Medicare cover dental, vision and hearing, does Medicare pay for hearing aids and does Medicare cover long-term care.
Does Medicare Advantage cover the same services?
Medicare Advantage plans are run by private companies that contract with Medicare. The handbook says they provide almost all medically necessary services and supplies Original Medicare covers. If you are in one, Original Medicare still pays for hospice care, kidney transplant costs and some costs of clinical research studies.
Plans may add extras, like some dental, vision or hearing care. Medicare & You says these benefits are generally limited, so check with the plan. Plans may also need you to get approval first for some services and use a network. Our article on Medicare Advantage HMO vs PPO explains networks.
How can you check whether Medicare covers something?
- Search the service on Medicare.gov's "Is my test, item, or service covered?" page, at Medicare.gov/coverage.
- Use Medicare's "What's covered?" mobile app, on the App Store and Google Play.
- Call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).
- Ask your provider what the test or service will cost before you get it.
- If you have a Medicare Advantage plan, call the plan or read its Evidence of Coverage.
Next steps
- Look up any service you expect to need on Medicare.gov/coverage.
- Book your "Welcome to Medicare" or yearly "Wellness" visit if you are due.
- List your doctors, prescriptions and the extras that matter to you before you compare plans.
- New to Medicare? Start with our Turning 65 checklist.
Talk with a licensed Boomers agent
A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions.
Find a licensed agent near you · See upcoming Medicare events
Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.
Frequently asked questions
Is the annual wellness visit the same as a physical?
No. The yearly "Wellness" visit is a talk about prevention and a plan for screenings and shots. Original Medicare doesn't cover routine physical exams. If extra tests are done during the visit, you may owe coinsurance or the full cost.
Does Medicare cover hospice care?
Yes. Part A covers hospice care for people who qualify, and you pay nothing for covered hospice services. You may pay up to $5 for each prescription for pain and symptom drugs. Original Medicare pays for hospice even if you are in a Medicare Advantage plan.
Does Medicare cover the shingles shot?
Yes, under Part D rather than Part B. Medicare.gov says you pay nothing for the shingles vaccine if you have Part D. Flu, pneumococcal and COVID-19 shots are covered under Part B.
Why might Medicare not pay for something my doctor recommends?
Medicare pays only for covered services, and some services only so often. Medicare.gov suggests asking your doctor why a service is recommended and what Medicare will cover. Some providers give you a written notice when they expect Medicare may not pay.
Sources
- Is my test, item, or service covered? (Medicare.gov)
- Yearly "Wellness" visits (Medicare.gov)
- "Welcome to Medicare" preventive visit (Medicare.gov)
- Colonoscopies (Medicare.gov)
- Physical therapy services (Medicare.gov)
- Chiropractic services (Medicare.gov)
- Emergency department services (Medicare.gov)
- Ambulance services (Medicare.gov)
- Medicare Coverage of Durable Medical Equipment & Other Devices (Medicare.gov)
- Shingles vaccines (Medicare.gov)
- Hospice care (Medicare.gov)
- Helpful tools (Medicare.gov)
- Medicare & You 2027 (Medicare.gov)
- 2026 Medicare Parts A & B premiums and deductibles (CMS.gov, November 14, 2025)
Talk with a licensed Boomers agent
A licensed agent can go over the Medicare plans we represent in your area, check them against your doctors and prescriptions, and answer your questions. There is no cost to you and no obligation to enroll.
Monday – Friday, 9 AM – 5 PM PT
