What Does Medicare Cover? A Guide by Condition
Medicare covers a great deal — but the rules differ by part, and what you pay depends on whether you have Original Medicare, a Medicare Advantage plan, or a Medigap policy. This guide breaks down coverage for the conditions and services people ask about most.
Original Medicare
Part A covers inpatient hospital and skilled nursing care; Part B covers doctors, outpatient care, and many tests and supplies. You can add a Part D plan for prescriptions and a Medigap policy to help with the 20% coinsurance and deductibles. You can see any provider nationwide that accepts Medicare.
Medicare Advantage
Advantage (Part C) plans bundle Parts A, B, and usually D, and often add extras like dental, vision, hearing, and fitness benefits. They use provider networks and may require prior authorization. Benefits vary by plan, county, and year, so the right plan depends on your conditions and doctors.
Coverage by Condition
How Medicare covers care for ongoing health conditions.
Yes. Medicare covers diabetes supplies, screenings, and treatment through Parts B and D — including blood sugar monitors, test strips, continuous glucose monitors, and diabetes self-management training. Insulin is capped at $35 per month under Medicare drug coverage.
Yes. Medicare covers cardiovascular care including hospital treatment, diagnostic tests, cardiac rehabilitation, and prevention screenings under Parts A and B. Most heart medications are covered under Part D.
Yes. Medicare covers cancer screening, diagnosis, surgery, chemotherapy, radiation, and many cancer drugs across Parts A, B, and D. Your cost depends on where you are treated and how the drug is administered.
Yes. Medicare covers COPD treatment including oxygen equipment, pulmonary rehabilitation, nebulizers, and many respiratory medications under Parts A, B, and D.
Yes. Medicare covers mental health care including therapy, psychiatric visits, inpatient treatment, and many psychiatric medications. As of 2024, Medicare also covers licensed counselors and marriage and family therapists.
Medicare covers diagnosis, doctor visits, cognitive assessments, and some treatments for Alzheimer’s and dementia, but it does not cover long-term custodial care like assisted living or full-time memory care.
Yes. Medicare covers chronic kidney disease care and dialysis, and people with End-Stage Renal Disease (ESRD) can qualify for Medicare at any age. Coverage includes dialysis, transplants, and many related medications.
Yes. Medicare covers Parkinson’s disease care through Parts A, B, and D — including neurologist visits, physical, occupational, and speech therapy, durable medical equipment like walkers, home health when you qualify, and the medications used to manage symptoms.
Yes. Medicare covers a bone density (DXA) scan every 24 months for people who qualify — at no cost as a preventive service — along with osteoporosis medications and care for fractures. Certain injectable osteoporosis drugs are covered under Part B for women who meet specific criteria.
Yes. Medicare covers stroke recovery across Parts A, B, and D — including hospital care, inpatient rehabilitation, skilled nursing facility rehab, outpatient physical, occupational, and speech therapy, home health when you qualify, and the medications used to prevent another stroke.
Partly. Medicare covers obesity screening and intensive behavioral counseling at no cost for people with a BMI of 30 or higher, and it covers bariatric (weight-loss) surgery when you meet the medical criteria. Part D generally cannot cover drugs used only for weight loss, though a medication may be covered when prescribed for another approved condition.
Coverage by Service
What Medicare pays for common services and care types.
Original Medicare does not cover routine dental care like cleanings, fillings, dentures, or extractions. Many Medicare Advantage plans include dental benefits, and standalone dental insurance is also available.
Original Medicare does not cover routine eye exams or eyeglasses, but it does cover medical eye care like cataract surgery and glaucoma screening. Many Medicare Advantage plans add routine vision benefits.
Original Medicare does not cover routine hearing exams or hearing aids. It does cover diagnostic hearing tests ordered by a doctor, and many Medicare Advantage plans add hearing aid benefits.
Yes. Medicare covers medically necessary physical therapy under Part B, and the annual dollar cap was eliminated in 2018. You typically pay 20% after the deductible.
Yes. Medicare covers part-time skilled home health care — including skilled nursing, therapy, and home health aide services — for homebound beneficiaries, usually at no cost for the covered services. A doctor must certify the need.
Chronic Condition Special Needs Plans (C-SNPs)
A Chronic Condition Special Needs Plan (C-SNP) is a type of Medicare Advantage plan limited to people living with a specific qualifying condition — such as diabetes, chronic heart failure, COPD, or certain neurological conditions. Because everyone in the plan shares that diagnosis, C-SNPs tailor their provider networks, drug formularies, and care coordination to that condition.
If you qualify, a C-SNP can offer richer condition-specific benefits and a care coordinator who helps manage your treatment. Availability varies by county, and you generally need a doctor to verify your diagnosis. C-SNPs use networks and prior authorization like other Advantage plans, so confirm your specialists are included before enrolling.
Find out if a C-SNP is available for your conditionNot Sure What Your Plan Covers?
A licensed advisor can review your conditions, doctors, and medications and compare the plans available in your ZIP code — at no cost.
Get My Free Plan ReviewThis information is for educational purposes. Consult your doctor for medical advice and a licensed Medicare advisor for plan coverage questions. Plan availability, benefits, and costs vary by ZIP code and change annually. HealthPlan Connect is not affiliated with or endorsed by the federal Medicare program or any government agency. Last reviewed 2026-06-10 by Lynsey Brennan, Licensed Medicare Advisor (FL License #G007269).