Medicare-Covered Treatments and Health Conditions

Medicare generally covers treatments and services that are medically necessary. That means beneficiaries typically qualify for treatment of common conditions that older Americans face.

Part B typically covers treatments in outpatient care. If you are an inpatient or hospitalized, then Part A covers your treatment. The same treatments are covered by Medicare Advantage plans, which are sold through private insurers, since they must include everything covered under Original Medicare at minimum.

Medicare does cover some supplies, services and treatments that relate to the management of diabetes. This includes things like insulin pumps and blood sugar or glucose testing monitors.

One key area related to diabetes that is not covered by Original Medicare is insulin, which is typically only available through a Part D prescription drug plan. Original Medicare also will not cover syringes or needles.

As with other treatments Medicare covers, you typically will pay 20% of the cost after you have met your deductible.

Medicare will cover many different treatments related to cancer. Under Part A, cancer treatments you receive as an inpatient are covered, as well as home health care and hospice care.

Under Part B, chemotherapy drugs and outpatient treatment are typically covered. Radiation treatments, outpatient surgeries and equipment are also covered.

There are some treatments and services related to having cancer that Medicare also covers. These treatments include screenings and diagnostic tests, as well as mental health services and breast prostheses after a mastectomy.

Medicare covers surgeries that are medically necessary. Part A will cover surgeries if you’re hospitalized as an inpatient, whereas Part B will cover outpatient surgeries. As with other Part B costs, you will pay 20% after you have met your deductible.

Medicare does not cover cosmetic surgeries, elective surgeries or procedures that don’t have medical value.

Neurological disorders can take many forms, but some of the most common types older Americans face are Parkinson’s and Alzheimer’s.

According to the U.S. Centers for Disease Control and Prevention, nearly six million Americans have Alzheimer’s alone.

Medicare can pay for some cost of care associated with Alzheimer’s, like hospital stays through Part A or hospice care. But long-term care or a permanent move to a nursing home is not covered.

There is also no cure for Alzheimer’s, and treatments in general are limited.

Medicare can also cover areas associated with Parkinson’s, including physical therapy and speech therapy. Services like physical therapy are typically covered in any setting, from inpatient to within your home.

Medicare will cover treatments associated with cardiovascular issues and heart disease.

Behavioral therapy that Medicare covers includes an annual discussion with your doctor to lower your risk of cardiovascular disease, a blood pressure check and tips on how to eat well.

Cardiac rehabilitation can help you get your heart health back on track after an event like a heart attack.

Both Parts A and B will cover different areas of your cardiovascular health depending on the specific type of treatment you are receiving.

Medicare covers several different types of respiratory procedures. One major area of coverage is pulmonary rehabilitation.

Pulmonary rehabilitation programs are covered for beneficiaries who have moderate or worse chronic obstructive pulmonary disease (COPD). The programs include exercise, education and treatment plans to help you recover from your condition.

Medicare will cover several other areas related to COPD as well, including treatments, oxygen and some medication.

Medicare may also cover oxygen equipment as a type of durable medical equipment.

Medicare offers coverage for a range of treatments and services related to mental health. Under Part A, beneficiaries are covered for mental health treatment that they receive while hospitalized as an inpatient.

Many types of outpatient mental health treatments are covered through Part B. This can include everything from family counseling to a psychiatric evaluation.

Most prescription drugs for mental health treatment are not covered under Original Medicare. You will need a Part D prescription drug plan to cover antidepressants and other prescribed drugs in relation to your mental health.

Original Medicare can cover a range of pain management therapies and treatments. Pain management is an all-encompassing term that can refer to a variety of options to manage discomfort. Medicare covers many of these treatments.

Medicare Part B will cover 80% of the cost for pain management therapies and treatments. Pain management through prescription drugs is typically only covered through a Part D plan. Original Medicare rarely covers prescription drugs.