What Medicare covers
What does Medicare cover?
Original Medicare is two insurances, Part A for hospital care and Part B for medical care, with drug plans under Part D. The estimator starts on a hospital stay; switch the service to see another part at work.
What this service costs you
You pay
$1,736
| Part A deductible | $1,736 |
Part A per benefit period: $1,736 deductible (days 1 to 60), $434 a day (61 to 90), $868 a reserve day.
How this is calculatedMedicare covers health care in three layers. Part A, hospital insurance, pays for inpatient hospital stays, care in a skilled nursing facility after a qualifying stay, hospice and part of home health care; in 2026 a hospital stay costs you the $1,736 Part A deductible for days 1 to 60 of a benefit period, so a 5-day stay leaves you $1,736, and a 30-day nursing facility stay after it leaves you $2,170. Part B, medical insurance, pays for doctors, outpatient care, preventive services, lab tests, imaging, ambulance rides and medical equipment, with a $283 yearly deductible and then 20% of the approved amount. Part D, sold by private plans, covers prescription drugs and the adult vaccines Part B does not, such as the shingles vaccine, which costs nothing with a Part D plan. Medicare Advantage plans, also called Part C, bundle Parts A and B and must cover at least the same services. What none of them covers in Original Medicare: hearing aids, routine dental care, eye exams for glasses and non-medical long-term care.
A hospital stay under Part A
You pay
$1,736
| Part A deductible | $1,736 |
| Daily coinsurance | $0 |
| Reserve days used | 0 |
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
The four parts of Medicare
- Part A, hospital insurance. Inpatient hospital care (semi-private room, meals, nursing, drugs given during the stay), skilled nursing facility care for a limited time after a qualifying hospital stay, hospice, and home health care when you qualify.
- Part B, medical insurance. Medically necessary services and preventive services: doctor visits, outpatient surgery, hospital outpatient care, lab tests, imaging, ambulance, durable medical equipment, mental health care, outpatient therapy and a limited list of drugs.
- Part C, Medicare Advantage. A private plan that replaces Parts A and B, covers at least the same services and often adds extras, with its own copays and a yearly limit.
- Part D, drug coverage. A private plan for prescription drugs and for the adult vaccines Part B does not cover.
Service by service: covered or not, and what you pay
Each line links to its page, with the rules of the service (how often, who qualifies, which provider) and an estimator set for it. "With conditions" means Medicare pays only in defined cases: acupuncture for chronic low back pain only, chiropractic care for spine adjustments only, glasses after cataract surgery only.
Hospital stays: days, not percentages
Part A does not charge 20%. It charges by the day, per benefit period: nothing after the deductible for days 1 to 60, $434 a day for days 61 to 90, then $868 a day for up to 60 lifetime reserve days, which can be used only once in a lifetime; after day 150 you pay all costs. A 95-day stay comes to $19,096. A private room, private-duty nursing and a television or phone billed separately are not covered.
How to check a service that is not listed here
Medicare.gov keeps a coverage page for each test, item or service, with who is eligible, how often it is covered and what you pay. Before a test or treatment, ask the doctor why it is recommended and whether Medicare will cover it: your doctor may propose services Medicare does not cover, or covers less often than proposed. What you owe depends on your other insurance, on how much the doctor charges, on whether the doctor accepts assignment, on the type of facility and on where you get the service. The estimator on this page handles the last three for the services it lists.
What Original Medicare leaves out
Eye exams for glasses, non-medical long-term care, cosmetic surgery, massage therapy, routine physical exams, hearing aids and the exams to fit them, concierge care, care from a provider who opted out of Medicare except in an emergency, and most dental care. The page on what Medicare does not cover details each one and the few exceptions, such as dental care linked to a heart valve replacement or dialysis.