Medicare Coverage A–Z
Plain answers to the "does Medicare cover X" questions seniors and adult children type into Google every day. Every page is sourced, reviewed by a licensed insurance professional, and updated when CMS guidance changes.
Prescription drug coverage
Coverage for branded medications under Medicare Part D and Part B.
Does Medicare Cover Eliquis?
Medicare Part D covers Eliquis for atrial fibrillation, DVT, and pulmonary embolism. Starting in 2026, Eliquis is one of the first ten drugs subject to Medicare's negotiated price — meaning costs are dropping for the first time.
Does Medicare Cover Mounjaro?
Medicare Part D covers Mounjaro for type 2 diabetes. Zepbound — the same drug, weight-loss brand — is not covered. Here's how the brand-vs-brand-vs-generic split works and what you'll actually pay.
Does Medicare Cover Otezla?
Otezla is covered under Medicare Part D for plaque psoriasis, psoriatic arthritis, and Behçet's disease — but it's typically on the specialty tier with prior authorization and high coinsurance.
Does Medicare Cover Ozempic?
Original Medicare covers Ozempic when it's prescribed for type 2 diabetes — not for weight loss. Here's exactly how Part D coverage works, what you'll pay, and what changes if your doctor switches you to Wegovy or Mounjaro.
Does Medicare Cover Tremfya?
Medicare Part D covers Tremfya (guselkumab) for plaque psoriasis, psoriatic arthritis, and ulcerative colitis — but only on the specialty tier with prior authorization and step therapy through cheaper biologics.
Does Medicare Cover Wegovy?
Medicare's Wegovy coverage changed in March 2024. Part D can now cover it — but only if you have established cardiovascular disease plus overweight or obesity. Coverage for weight loss alone remains excluded.
Service & care coverage
Coverage for medical services, procedures, and long-term care needs.
Does Medicare Cover Assisted Living?
Medicare does not pay for assisted living facility costs. It pays for medical care delivered inside one. The distinction is the difference between a $0 surprise and a $5,500/month bill.
Does Medicare Cover Cataract Surgery?
Medicare covers standard cataract surgery, including the basic monofocal lens. It does not cover the upgrade to premium multifocal or toric lenses. Here's exactly what the upgrade costs and when it's worth it.
Does Medicare Cover Dental?
Original Medicare doesn't cover routine dental care. Medicare Advantage dental benefits are common but limited. The gap created an entire dental insurance secondary market — here's how to navigate it.
Does Medicare Cover Hearing Aids?
Original Medicare doesn't cover hearing aids — but many Medicare Advantage plans now do, and the 2022 OTC hearing aid law has changed what that coverage is competing against.
Does Medicare Cover Memory Care?
Medicare doesn't cover memory care residency. It does cover doctor visits, prescriptions, hospice, and home health for someone with Alzheimer's or other dementias. Here's how to plan around the gap.
Does Medicare Cover Physical Therapy?
Yes — Medicare Part B covers physical therapy with no hard cap on visits when medically necessary. Here's how the cost-sharing works, what triggers the KX modifier above $2,410, and where outpatient PT fits versus inpatient rehab.
More coverage pages coming
We're publishing new coverage breakdowns each month, prioritized by how often seniors search for them. If you have a specific question we should cover, let us know — we read every email.
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