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What It Covers
If you get Medicare coverage, it helps with many different types of medical expenses. The exact coverage you have depends on:
- Whether you have a Medicare Advantage plan or Original Medicare
- If you have Medicare Advantage, which plan you have
- If you have Original Medicare, whether you have Part B and Part D, and, if so, which Part D plan you have
What Full Medicare Coverage Usually Offers
This list presents many of the medical expenses that Original Medicare Parts A and B help pay for. Medicare Advantage plans also pay for all of these services, but some plans also pay for more services not listed here. For all of these, you may have to pay copayments, co-insurance, or a deductible. Learn more about what Medicare costs and how to get help paying for it.
Part A and Medicare Advantage plans both cover hospitalization expenses, including:
- Medical care when you are admitted to the hospital
- Hospital stays
- Short-term stays in a skilled nursing facility
- Hospice care
Part B and Medicare Advantage plans both cover outpatient expenses, including:
- Medical care when you are not in the hospital
- Preventive screenings and services, including an annual checkup and some vaccines
- Lab tests, such as X-rays, MRIs, and blood tests
- Home health care
- Emergency services, including ambulance transit and emergency room treatment
- Medical and surgical services and supplies
- Mental health care
- Urgent care
- Doctor and practitioner services
- Rehabilitation, such as physical therapy or speech therapy
- Supplies and equipment, such as prosthetics, orthotics, diabetes supplies, or wheelchairs
- In some situations, other things like chiropractic services, eye exams, eyeglasses, diabetes management, hearing and balance exams, and injectable cancer or immunosuppressive drugs.
Part D and Medicare Advantage plans that include drug coverage pay for prescription drugs on a plan’s formulary. Formularies are reviewed by Medicare and must cover certain types of medications.
Get more information about what Medicare covers:
- For Original Medicare, read Medicare & You or download Medicare's "What's Covered" app from Google Play or the Apple App Store.
- For Part D, a Medigap policy, or Medicare Advantage, contact your private insurance company.
- See Medicare.gov’s list of services that Original Medicare doesn’t cover, such as dental care, eye exams, hearing aids, cosmetic surgery, and acupuncture.
Long-term care includes help with things like bathing, getting dressed, and using the bathroom. You might get this help in your home, elsewhere in the community, or at a skilled nursing facility. If you have low income and low resources, the Arizona Long Term Care System (ALTCS) may help pay for these costs.
If you need long-term care and have Medicare, you can:
- Read Medicare.gov’s introduction to long-term care.
- Visit LongTermCare.gov to get an introduction to long-term care issues and decisions.
- Contact the Arizona State Health Insurance Assistance Program (SHIP) at 1-800-432-4040 with questions about how Medicare covers your long-term needs.
- Get in touch with the Division of Aging and Adult Services (DAAS) for more information about your options. Find your local DAAS Area Agency on Aging.
Learn more
AHCCCS for People with Disabilities
There are more ways to qualify for AHCCCS if you have a disability.
AHCCCS Freedom to Work
AHCCCS Freedom to Work is AHCCCS for people with disabilities who work.
Supplemental Security Income (SSI)
SSI helps people with disabilities and seniors who have low income and resources.
Get Expert Help
Ask an Arizona Work Incentive Consultant your questions about work and benefits.
1-866-304-WORK (9675)
A Work Incentive Consultant is a trained expert who can help you understand Social Security work incentives, disability benefit programs, and how they are impacted by work. Their goal is to help you transition to work and make a sustainable financial plan for your future.
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