What Medical Procedures Does Medicare cover?
Medicare has provided health insurance for over 59.9 million individuals, according to the 2019 Medicare Trustees Report.
Medicare is a federal government health insurance program in the United States that provides health care coverage for Americans aged 65 and above, under 65 and receiving Social Security Disability Insurance (SSDI), and also for younger people with End-Stage Renal Disease (ESRD), and Lou Gehrig’s disease or also referred to as Amyotrophic Lateral Sclerosis or ALS.
And as part of the 2019 Medicare Trustees Report, Medicare has reached out to more than 52 million people aged 65 and older and about 8 million younger people
Many people want to know what medical procedures does Medicare cover. Here is an elaborate explanation of how Medicare works.
Medicare has four parts:
- Part A is Hospital Insurance (Inpatient)
- Part B is Medical Services Insurance (Outpatient)
- Part D is Prescription Drug Plans, though some are covered by Part B.
- Part C is Medicare advantage plans
All Medicare benefits are subject to medical necessity.
Medicare covers many tests, services, and procedures depends on where you live. Here is the list of tests and procedures that can be covered regardless of where you live, including the latest Coronavirus or Covid-19 tests:
- Abdominal aortic aneurysm screenings
- Acupuncture
- Advance care planning
- Air-fluidized beds
- Alcohol misuse screenings & counseling
- Ambulance services
- Ambulatory surgical centers
- Anesthesia
- Artificial eyes & limbs
- Bariatric surgery
- Behavioral health integration services
- Blood
- Blood processing & handling
- Blood sugar monitors
- Blood sugar test strips
- Bone mass measurements
- Braces (arm, leg, back, & neck)
- Breast prostheses
- Canes
- Cardiac rehabilitation programs
- Cardiovascular behavioral therapy
- Cardiovascular disease screenings
- Cervical & vaginal cancer screenings
- Chemotherapy
- Chiropractic services
- Chronic care management services
- Clinical laboratory tests
- Clinical research studies
- Commode chairs
- Concierge care
- Continuous passive motion devices
- Continuous Positive Airway Pressure devices, accessories, & therapy
- Coronavirus disease 2019 (COVID-19) antibody test
- Coronavirus disease 2019 (COVID-19) tests
- Cosmetic surgery
- Counseling to prevent tobacco use & tobacco-caused disease
- Crutches
- Defibrillators
- Dental services
- Depression screenings
- Diabetes prevention program
- Diabetes screenings
- Diabetes self-management training
- Diagnostic laboratory tests
- Diagnostic non-laboratory tests
- Dialysis (children)
- Dialysis services & supplies
- Doctor & other health care provider services
- Durable medical equipment (DME) coverage
- E-visits
- EKG or ECG screenings
- Emergency department services
- Enteral nutrition supplies & equipment
- Eye exams (for diabetes)
- Eye exams (routine)
- Eyeglasses & contact lenses
- Federally Qualified Health Center (FQHC) services
- Flu shots
- Foot care
- Foot care (for diabetes)
- Foot care (routine)
- Glaucoma tests
- Glucose control solutions
- Gym memberships & fitness programs
- Hearing & balance exams
- Hearing aids
- Hepatitis B shots
- Hepatitis B Virus infection screenings
- Hepatitis C screening tests
- HIV screenings
- Home health services
- Hospice care
- Hospital beds
- Humidifiers
- Hyperbaric oxygen (HBO) therapy
- Incontinence pads & adult diapers
- Infusion pumps & supplies
- Inpatient hospital care
- Inpatient rehabilitation care
- Insulin
- Kidney disease education
- Kidney transplants
- Kidney transplants (children)
- Lancet devices & lancets
- Long-term care
- Long-term care hospital services
- Lung cancer screenings
- Macular degeneration tests & treatment
- Mammograms
- Massage therapy
- Mental health care (inpatient)
- Mental health care (outpatient)
- Mental health care (partial hospitalization)
- Multi-target stool DNA tests
- Nebulizers & nebulizer medications
- Nursing home care
- Nutrition therapy services
- Obesity behavioral therapy
- Occupational therapy
- Opioid use disorder treatment services
- Organ transplants
- Orthopedic shoes
- Osteoporosis drugs
- Ostomy supplies
- Outpatient hospital services
- Outpatient medical & surgical services & supplies
- Oxygen equipment & accessories
- Pain management
- Pancreas transplants
- Patient lifts
- Physical therapy
- Pneumococcal shots
- Prescription drugs (outpatient)
- Pressure-reducing support surfaces
- Preventive & screening services
- Prostate cancer screenings
- Prosthetic devices
- Pulmonary rehabilitation programs
- Radiation therapy
- Religious nonmedical health care institution items & services
- Rural health clinic (RHC) services
- Screening barium enemas
- Screening colonoscopies
- Screening fecal occult blood tests
- Screening flexible sigmoidoscopies
- Second surgical opinions
- Sexually transmitted infections screenings & counseling
- Shingles shots
- Skilled nursing facility (SNF) care
- Sleep studies
- Speech-language pathology services
- Suction pumps
- Supplies
- Surgery
- Surgical dressing services
- Swing bed services
- T-dap shots
- Telehealth
- Therapeutic continuous glucose monitors (CGMs)
- Therapeutic shoes & inserts
- Traction equipment
- Transitional Care Management Services
- Travel
- Urgently needed care
- Virtual check-ins
- Walkers
- “Welcome to Medicare” preventive visit
- Wheelchairs & scooters
- X-rays
- Yearly “Wellness” visits
This list doesn’t entail everything, which is why it is essential to ask and talk to your health care provider if Medicare can cover the test or procedure that you need.
Amid the Covid-19 pandemic, CNBC reports that the Centers for Medicare and Medicaid Services announces a rule change that will allow beneficiaries to get a free Covid-19 vaccine if approved via emergency-use authorization. Read the full report here. Medicare will cover early vaccines for Covid-19.
And the nearing U.S. presidential elections might affect and give changes to health insurance plans, enrollments, and coverages. It is also stated that some Medicare benefits are bound to change in 2021. Lastly, Medicare is now open for enrollment to December 7. Visit Medicare.gov to know how to apply. Talk to your doctor and learn what medical procedures does Medicare cover.
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