Does Medicare Cover That?

A quick guide to finding out whether Medicare approves a service — using the free tools Medicare already gives you.

Introduction

At some point, almost everyone with Medicare asks the same question: "Wait — does Medicare actually cover that?" It's a fair question, because what Medicare approves can get confusing.

The good news is you don't have to guess or wait on hold. There are two quick, free ways to look up whether a specific service is covered, and you can use either one in just a couple of minutes.

Option 1: Search on Medicare.gov

The official Medicare.gov website has gotten better year after year, and it's the most reliable place to check what's covered.

Here's the quick version:

1. Look for the search button — a small magnifying-glass icon near the top-right of the page. (Medicare updates the site often, so its exact spot can move a little.)

2. Click it, and a search box appears. Type in whatever service you're wondering about — for example, "vision."

3. You'll get a list of related results, such as eye exams, glaucoma tests, or eyeglasses. Click any result to see the details.

   
   

If you notice something isn't covered — say, routine eye exams — try searching with more specific words. A little experimenting with keywords usually gets you to the answer.

Option 2: The "What's Covered" Mobile App

Medicare also offers a free app called "What's Covered," which does the same thing as the website search — just from your phone.

This one really shines when you're away from your computer. You can look up a service in seconds, even while you're sitting in the doctor's office. You can download it from the Apple App Store or Google Play.

What If Medicare Doesn't Cover It?

If Original Medicare doesn't cover a service, that's not always the end of the story. A few things are worth knowing:

• Medicare Advantage (Part C) plans sometimes include extra benefits that Original Medicare doesn't — so a service Medicare skips might still be covered under one of these plans.

• Medicare Supplement (Medigap) plans generally only pay their share after Medicare approves a service as the primary payer. If Medicare doesn't approve it, the Medigap plan typically won't either.

  
  

This is exactly the kind of thing we're happy to help you sort out, so you're never guessing about what your specific plan does and doesn't include.

Want to Know the Cost First?

If you're trying to estimate what an outpatient procedure might cost, Medicare has a tool for that, too — the Procedure Price Look-Up. You can enter a procedure and get a ballpark price.

Keep in mind that your actual cost could be lower once any supplemental coverage you have is factored in. Find the tool at medicare.gov/procedure-price-lookup.

Helpful Reference Links

• Procedure Price Look-Up: medicare.gov/procedure-price-lookup

• "What's Covered" app: available on the Apple App Store and Google Play