What's covered
What’s covered helps you understand the health care coverage offered by Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
Use this federal government app to:
-Answer your Medicare coverage questions
-See information about your costs
-Learn about covered items & services
-See notes & where to get more information
-Browse free preventive services
Original Medicare Items & Services
Find out what your Medicare coverage has to offer like:
- When are mammograms covered?
- Is home health care covered?
- Will Medicare pay for diabetes supplies?
Preventive Health Coverage
Medicare coverage includes preventive services at no cost to you. Preventive services can help keep you healthy by finding health problems early and can keep you from getting certain diseases.
What’s covered will help you answer questions like:
- Will my Medicare benefits cover services to help me stop smoking?
- Can I get a cervical cancer screening?
- How often will my Medicare coverage allow me to get a bone mass measurement?
Ask your doctor or health care provider which preventive services (like screenings, shots, and tests) you need to get.
Part A & Part B Costs
Medicare Part A and Part B cover certain medical services and supplies in hospitals, doctors’ offices, and other health care settings.
Part A hospital insurance coverage helps pay for inpatient care in a hospital, inpatient care in a skilled nursing facility, hospice care, home health care, or inpatient care in a religious nonmedical health care institution. Copayments, coinsurance, or deductibles may apply for each service.
Part B medical insurance coverage supports medically necessary doctors’ services, outpatient care, home health services, durable medical equipment, preventive services, and other medical services. Under Original Medicare, if the Part B deductible applies, you must pay all health care costs (up to the Medicare-approved amount) until you meet the yearly Part B deductible. After your deductible is met, Medicare begins to pay its share and you typically pay 20% of the Medicare-approved amount of the service, if the doctor or health care provider accepts assignment. There’s no yearly limit for what you pay out-of-pocket.
For some items and services, you must meet eligibility criteria or you may be responsible for paying all costs. Your doctor or health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Use the What’s covered app to answer questions like:
-How much will I pay for prescription drugs included in Medicare Part B coverage?
-Does the Part B deductible apply for cardiac rehab?
-What percentage of the Medicare-approved amount will I need to pay for colorectal cancer screenings?
What’s Not Included
What’s covered doesn’t contain information on Medicare Advantage Plan, other Medicare health plan, or Medicare Supplement Insurance (Medigap) coverage. It doesn’t contain a CPT code search, exact costs on surgeries or procedures, or local coverage decisions.
Medicare Advantage Plans
If you have a Medicare Advantage Plan or other Medicare health plan, you have the same basic health care coverage as people who have Original Medicare, but the rules vary by plan. Some Medicare Advantage Plans offer extra benefits that Original Medicare doesn’t cover - like vision, hearing, or dental. Check with the plan or search in the App or Google Play Store to see if the plan has a similar mobile application.
This is Medicare’s first official app, and we value your feedback. Please tell us your thoughts by rating What’s covered.
Category : Medical
Reviews (30)
It takes a long time to start up, and some of the text overlaps. The intent is good, but the execution is tuition still needs work.
The app is very limited. it only lists major catagories. i was wondering if Dupuytren's contracturre was covered. i got to "dup" and it said 'mothing found. For this app to be valuable, it needs to be able to tell you, 'No, that's not covered,' not just give you a 'not found." Basically a waste, unless you just want to confirm if what you already know. I'm actually surprised this app has a 2.8 rating.
Collapses in the starting block. The search function is worthless. Can't find even common surgeries by name or anatomical location. The best to hope for is search on "Surgery" and get the comprehensive and informative result that "Many medically necessary surgeries are covered." Absolutely brilliant...
I believe this app was released before it was developed to answer the questions described in it's description of what it's supposed to do as any of the searches I tried to get answered came up with "no results". I would have expected at least 1 hit of the 20 or so searches I tried to enter, which I thought were fairly obvious to determine if something was a covered service or not, services I've either had done or about to have done. I don't think this app is ready by a long shot.
App is terrible on droid. Font sizes too big doesn't all fit on the screen. You type in what your problem is and the very limited index defaults to General categories. Very useless shockingly of poor quality surprising that they're even advertising this as an app. Amateurish poorly designed and useless. Somehow I expected more from our federal government.
I was unable to find any of procedures/testing I was trying look for. Then I tried to look up some more common thing and the results returned were more irelivent to what was typed. Overall this app is as usfull as a screen door on a submarine.
Absolutely worthless, look up CT scan and get no results. Look up low-dose computed tomography and you get absolutely no results. Try and determine how often a patient with lung cancer can have lung CT scans and you cannot determine it at all from this app. This app is not made for a patient and you cannot look up anything in lay terms, you also cannot look up anything using the scientific terms. So why did you bother to make it?
Slow to open and allow typing in search box. No complete answers. I downloaded what shows to be the 2021 coverage information, but the downloaded document is the 2020 coverage information. Looks like the document title was changed, but not the documents itself.
So, so, MANY more items needed in the database before this app can be truely useful. Nothing for "biopsy" or "MRI" (not even a "scan" or "CAT" or "imaging" reference)… not even anything more specific than simply "surgery". Why not? Why not a few cross-references too? OK, it's a good start… I do appreciate the effort… but please give us monthly database updates to REALLY give it value.
Like many other reviews the search function is useless unless you know the exact phrase Medicare uses. I have never been able to find if something is covered or not. Unless the search function is greatly improved this is worthless.
Agree with other reviewer that this app may be somewhat premature and in need of further development. I found more listings for "uncovered" items than actual "covered" proceedures. It would seem that listing "uncovered" would be the same as doing work that needs not be done and that anything not listed would not be covered.
I appreciate that Medicare is trying to make an app to help us know what is covered and how often. However, I am surprised to see that the app was released at a somewhat early stage of development. Compared with the information available on the web site, this app is lacking much information, thus making its usefulness very limited. I will check back every now and then. If the functionality becomes more like the functionality of searching on the web site, this app has very good potential.
I am 65 & just signed up for Medicare. Before I installed the app, I read the reviews, most of which were dismal. i fully expected to uninstall it after trying it out. After I downloaded & tested it, I note that this is not a source of medical information, like "WebMD". It is a tool limited to briefly describing Medicare Part A&B insurance coverage. The search engine does indeed suck, and needs a lot of improvement, but the topic browser is helpful, if terse, so I will use it for now.
Can't even type the procedure in the search box... totally useless app...
The search function needs work. If you go to "Browse All Items" and look in the "M" section for MRI, you cannot find it. However, if you don't go there and simply type MRI in the "Is my item or service covered" it can be found in a Diagnostic Non-Laboratory category. Interestingly, Xrays are in the Browse index but MRIs are not. One other glitch, if you type "Xrays" it can be found, however, if you accidentally type Xrays with a space after it, (Xrays ) it won't be found.
Forget search, it's useless. Go to the INDEX and look for your subject. Only offers main topics, NOT individual procedures. ATTN TECH DEPT... I suggest you just upload the entire Medicare coverage and then install a GOOD search engine like SOLR Apache. Good luck. I'll keep you around to give you a chance to improve, but don't take too long...this is the digital age, and we need this yesterday. 😜
When I saw the display saying "Is my item or service covered?" I thought I could look up specific service codes related to my condition. Wrong! I could only locate generic topics with no specific yes/no answer relating to me. To me, the answer to a question "Is covered?" is a yes or a no answer. This app did not provide it, only "Topic not found. " i am greatly disappointed...
Three stars for a good government idea, and for advertising broadly to Seniors. Minus 2 stars for a low search hit rate for my trial.. Maybe broadening the index with more surgery, treatment, and illness terms leading to brief treatment lists will help in future. A hopeful start, at least.
I am disappointed at the level of information this app provides. It offers very limited, generic "yes" or "no" answers. I don't know, I guess I was just hoping for more, since Medicare has so many benefits that recipients are unaware of what questions to even ask to start to with, if that makes sense. Kinda still leaves you confused.
I was hesitant to download after reading the reviews, but i thought most of the reviews are from January 2019 and as bad as they are they must have put a little more thought into it by now, BUT I WAS WRONG. I tried searching for common terms and Nothing, i tried searching for things that previous reviews complained about, Nothing. i thought this was an ongoing project and i could expect to find more info as time goes by BUT I WAS WRONG AGAIN.
I really like this app. My mother just had a stroke so helpful having info on what Medicare covers like the section on DME for hospital beds, walkers and wheelchairs. Also helpful to read about long team care and skilled nursing facility coverage, and home health coverage. I went through the Browse All Items and Services section and read all info that applied to my needs. I like the information at the bottom of each topic Cost and What It Is. I'm happy Medicare covers more than I thought it did
This app is absolutely horrible. Of your looking for a specific type of Dr, a specialist, be prepared to scroll through hundreds of name with no organization. I was looking for a specialist and it listed just as many drs that weren't specialized in the area I needed as the Ines who were actually practicing the specialty I was looking for. I've yet to find any Dr listed that did accept Medicaid like they're supposed to. It's useless.
You must type in an exact match to find the procedure or test. If you do find it, the details given are very limited. I was looking for a "Diabetic eye exam" but it's listed as "Eye exam (Diabetic)" so no hit on the first try. I was looking for which specific tests are included but it doesn't touch on that at all.
I received an email from CMS about this App so OK I will try it. I had a question about a surgical procedure related to a private matter. Tried multiple searches and came away not anymore informed than before. The app needs a men's FAQ and a women's FAQ. It may not be PC but we are different.
Just downloaded app. Typed in "knee replacement" nothing found?? Tried "hip replacement," again nothing. Tried "joint," again zip, nada, nothing. Really? After submitting this review for the benefit of others, I will be uninstalling app for the benefit of me. Waste of time.
Great. First thing I searched was cholesterol and brain scan, found neither. Absolutely nothing. Already a POS app like most employees who cannot answer the simple questions I ask. Thought this would be smarter. Obviously not. Author/coder cannot even spell/grammar check info under install button.
I appreciate the effort made for this but I would really like to know exactly how much did we, the taxpayers pay for some private company to make this app? I'd really like for you guys at the Federal government to get our money back. It's like a lot of time was put into making the first page look good and like we're about to experience a state of the art app then they took our money and ran off to Tahiti and nobody at the Federal gov checked the work. They just uploaded it. smh more wasted $$$
Like most information from Medicare, it's almost impossible to get to what you want. The terms do not translate to normal conversational English. We don't all know the exact names/spelling of disorders. Medicare needs to do a better job at making the date accessible for all of us.
Even though more than half the reviews of this app were negative, i found it exceptionally informative & easy to navigate. Categories up to date, instructional & quick to access.
I was disappointed. I thought there would be a matrix that I could download on my computer or phone listing various conditions or situations that I could browse with columns showing: fully covered, partially covered or not covered and would tell how much is covered if not fully covered. A clear, concise overview would be helpful. In other words, what is behind the query.