7 Surprising Things Covered by Medicare – From Mental Health Services to Diabetes Management
Key takeaways:
Medicare is a federal health insurance program that consists of four parts: A,B,C, and D. Each part provides coverage for specific types of services.
You may already know that Medicare covers visits with healthcare professionals, as well as lab tests. But there are other items it covers that you may not be aware of.
From diabetes self-management training to telehealth services, Medicare provides coverage for services and items that can help you improve your condition.
Table of contents
Understanding the ins and outs of health insurance can be complicated, and Medicare is no different. When you enroll in Medicare, you have to learn how the different parts of the program work and what each part covers. As healthcare costs continue to rise, it’s even more important to know what Medicare pays for so you can plan ahead.
Although you may know that Medicare covers hospital stays and visits with healthcare professionals, there is a wide range of other services for which you can receive coverage.
How does Medicare coverage work?
Medicare is a federal health insurance program that provides coverage to eligible individuals who are age 65 or older, as well as certain younger individuals with disabilities or specific medical conditions. Medicare coverage is divided into different parts, each of which provides coverage for specific types of healthcare services.
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Here’s a breakdown of Medicare Parts A, B, C, and D:
Medicare Part A (hospital insurance): This covers services such as lab tests, hospital stays, and skilled nursing facility care.
Medicare Part B (medical insurance): This covers outpatient services such as durable medical equipment (DME) and visits with healthcare professionals. DME includes medical devices — such as wheelchairs, walkers, or hospital beds — that help individuals manage medical conditions, disabilities, or injuries at home. They must meet specific Medicare criteria.
Medicare Part C (Medicare Advantage): This coverage is offered by private insurance companies. It includes benefits from Part A, Part B, and sometimes Part D. You may also get extra benefits including dental, hearing, and vision.
Medicare Part D (prescription medication): This provides coverage for prescription medications through private insurance companies.
What surprising services and supplies qualify for Medicare coverage?
Medicare covers a wide range of services and supplies to help beneficiaries prevent, diagnose, manage, and improve their conditions. Here are seven little-known benefits that you may be eligible to receive if you meet the requirements.
1. Acupuncture
Medicare covers acupuncture for chronic lower back pain if you meet the requirements. Under Medicare Part B, you can get up to 12 acupuncture sessions in 90 days. However, if the acupuncture works for your pain and you show improvement, you can receive an additional 8 sessions, for a maximum of 20 treatments per year. If your condition worsens, Medicare won’t cover additional treatments.
Also, if you want Medicare to cover acupuncture, you’ll need to receive treatment from a licensed healthcare professional, such as a doctor or nurse practitioner. The professional must have received the minimum education requirements from a school accredited by the Accreditation Commission for Acupuncture and Herbal Medicine.
2. Mental health services
Medicare recognizes the importance of supporting people with anxiety, depression, schizophrenia, and other mental health conditions. The program provides coverage for outpatient and inpatient mental healthcare to diagnose and treat your condition. You may even receive coverage for your prescription medication if you have Medicare Part D or a Medicare Advantage plan.
Medicare does not cover everything. From weight-loss medications to routine dental care, here are surprising things not covered by Medicare.
Is Medicare Part A free? Your eligibility for premium-free Medicare Part A depends on your work and tax histories.
What does Medicare Part B cover? From mental health support to preventive services, here are examples of what Medicare Part B covers.
Some common medications that may be covered under your plan include:
Fluoxetine (Prozac)
Escitalopram (Lexapro)
Sertraline (Zoloft)
Alprazolam (Xanax)
3. Telehealth services
Telehealth services can be a convenient option for Medicare beneficiaries, especially in certain situations. For example, if you need a routine checkup or followup, you can use a phone or computer to talk to your healthcare professional instead of leaving your house.
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But Medicare is only covering telehealth services at your home or any other location in the country until December 31, 2024. After that, Medicare will require you to be at a medical facility or an office in a rural area (in the U.S.) for most telehealth services.
If you’re interested in receiving telehealth, here are a few services that Medicare will cover:
Office visits
Wellness visits
Mental health counseling
Prescription medication renewals
Monthly end-stage renal disease visits for home dialysis
4. Opioid use disorder treatment
The opioid crisis has been a significant public health concern in the country. Medicare has taken several steps to address the epidemic and provide support to individuals affected by it.
Under Medicare Part B, you can receive coverage for opioid use disorder treatment services in opioid treatment programs. If you need treatment, here are some of the services Medicare will cover:
Drug testing
Individual and group therapy
Overdose education
Periodic assessments
Substance use counseling
5. Nutrition therapy services with a qualified professional
If you need medical nutrition therapy services, Medicare will cover them if they’re provided by a registered dietitian or other qualified nutrition professional. To receive this benefit, you must be referred by a healthcare professional and have had kidney disease, diabetes, or a kidney transplant in the last 3 years.
Some of the services that Medicare may cover include:
Nutrition and lifestyle assessment
Individual nutritional therapy services
Followup visits with your healthcare professional
6. Diabetes management
If you’ve been diagnosed with diabetes, you can receive outpatient diabetes self-management training under Medicare Part B. Here’s what’s covered:
1 hour of individual training
9 hours of group training
2 hours of followup training every year, if eligible
Diabetes self-management training can be beneficial if you need to better manage and cope with your condition. The program can guide you on how to:
Improve your physical activity
Develop healthy eating habits
Check blood glucose levels
Take prescribed medications as needed
Reduce the risk of making your condition worse
7. Home healthcare
While Medicare doesn’t cover long-term care services to assist with daily activities such as bathing and using the bathroom, there are other support services that may be covered because they are considered medical care.
For example, if you’re homebound with an illness or injury, Medicare Parts A and B may cover the following home healthcare services:
Part-time skilled nursing care that is medically necessary
Physical therapy
Occupational therapy
Speech language therapy
Home health aide services
Medical social services
Medical supplies
Medicare doesn’t automatically cover home healthcare services for everyone enrolled in the program. You must meet certain requirements to receive home healthcare coverage, including having a qualified healthcare professional certify that you are homebound and proving that you need a specific service or treatment for your condition.
If you qualify, Medicare pays for home healthcare services for as long as you are eligible.
What is commonly not covered by Medicare?
While Medicare provides extensive coverage for a wide variety of medical services and treatments you may need, it doesn’t cover everything. It’s important to review your plan and determine what’s not covered so you can plan ahead for potential out-of-pocket expenses.
Here are some services that are generally not covered under original Medicare (Parts A and B):
Eye exams for eyeglasses or contact lenses
Custodial care (long-term care)
Massage therapy
Preventive teeth cleanings
Wisdom tooth removal
If you have a Medicare Advantage plan, you may receive coverage for services that original Medicare doesn’t cover, such as dentures and dental bridges.
How much will I pay out of pocket with Medicare?
If Medicare doesn’t cover your service, you will pay 100% of the costs. However, if you have Medicare, your out-of-pocket costs will depend on the following:
Specific parts of Medicare you are enrolled in
Services you receive
Providers you choose
Individual circumstances and medical condition
Here are some of the costs you will have to consider if you have Medicare:
Premium: If you have Medicare Part B, you’ll have to pay a premium. Part B costs can change every year, and they’re typically deducted from your Social Security checks if you receive them. For example, the standard Part B monthly premium for 2025 is $185.00, up from $174.70 in 2024. If you have Medicare Part A and paid Medicare taxes for long enough (typically at least 10 years), you won’t have to pay a monthly premium for Part A.
Deductible: This is the amount you must pay before Medicare splits the bill with you. For 2025, you’ll have to pay a $1,676 deductible ($1,632 in 2024) for each inpatient hospital benefit period, and there’s no cap on the number of benefit periods you can have every year.
Copay: This is the amount you pay out of pocket for a visit with a healthcare professional or a prescription medication.
Frequently asked questions
No. Medicare does not cover 100% of hospital bills. While it provides coverage for inpatient services — such as hospital care, hospice, and skilled nursing facility stays after hospitalization — there are limits to what Medicare covers. Costs such as deductibles and copays may also apply.
Medicare Part A (hospital insurance) is typically free if you or your spouse paid Medicare taxes for at least 10 years (or 40 quarters) through employment. However, you may still have to pay deductibles and coinsurance for the services covered under Part A.
The bottom line
Medicare’s coverage goes beyond your typical visits with healthcare professionals. If you have a medical condition such as diabetes, there are various ways you can get treatment and services under Medicare. From screenings to nutrition counseling, Medicare helps beneficiaries manage the costs associated with various conditions.
It’s important to review your Medicare benefits carefully and make sure you understand the requirements you need to meet to receive coverage. Even with Medicare coverage, you may still have to pay out-of-pocket expenses such as premiums, deductibles, and copays.
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References
Centers for Medicare & Medicaid Services. (2024). 2025 Medicare Parts A & B premiums and deductibles.
Medicare.gov. (n.d.). Cosmetic surgery.
Medicare.gov. (n.d.). Diabetes self-management training.
Medicare.gov. (n.d.). Long-term care.
Medicare.gov. (n.d.). Medical nutrition therapy services.
Medicare.gov. (n.d.). Opioid use disorder treatment services.
Medicare.gov. (n.d.). Telehealth.
UnitedHealthcare. (n.d.). Dental benefits with a Medicare Advantage plan.
