By Janice Tolj, MBA — Founder, Healthy Essentials After 50. Last updated September 1, 2026.
Affiliate disclosure: some articles linked here contain affiliate links. If you buy through one, I may earn a commission at no additional cost to you.
Medicare covers hospital care, doctor visits, and medical equipment you use at home. It does not cover routine dental, vision, hearing aids, long-term custodial care, or home modifications. Most of the confusing cases come down to a single rule about whether an item would be useful to a healthy person.
The One Rule Worth Learning
I spent several years managing my mother’s Medicare, and the thing that took me longest to understand was not the paperwork. It was why some obviously sensible things were paid for and other obviously sensible things were not.
Once I found the rule, most of it made sense. For Medicare to cover a piece of equipment, five conditions have to be met, and the one that decides nearly every argument is this: the item must not be useful to a person without an illness or injury.
A hospital bed passes. A healthy person has no use for one. A walk-in tub fails, because anybody can bathe in it, however clearly it prevents a fall. That single clause is why Medicare will pay for a wheelchair but not the ramp to get it up your front steps, and why it buys a commode chair but not the grab bar beside the toilet.
It is not a rule about what helps you. It is a rule about what is medical. Once you can apply it yourself, you can predict most answers before you call anyone.
The Four Parts, Briefly
| Part | What it is | What it pays for |
| Part A | Hospital insurance, usually premium-free | Inpatient hospital stays, limited skilled nursing facility care, hospice, some home health |
| Part B | Medical insurance, $202.90 a month in 2026 | Doctor visits, outpatient care, preventive services, durable medical equipment |
| Part C | Medicare Advantage, sold by private insurers | Everything A and B cover, plus extras such as dental, vision, hearing, and OTC allowances |
| Part D | Prescription drug coverage | Outpatient prescriptions. Parts A and B do not cover them |
Medigap, also called Medicare Supplement, is separate again. It does not add benefits. It pays the share Original Medicare leaves to you, which with Plan G generally means your only cost for covered services is the annual Part B deductible.
Does Medicare Cover It? A Quick Reference
This is the table I wish someone had handed me. Everything below refers to Original Medicare. Advantage plans often add benefits, so check your own plan for anything marked no.
| Covered? | The detail that matters | |
| Hospital stays | Yes | Part A, after the deductible for each benefit period |
| Doctor visits | Yes | Part B, 20 percent after the deductible |
| Annual wellness visit | Yes | No cost to you |
| Skilled nursing facility | Partly | Up to 100 days per benefit period, and only after a qualifying 3-day inpatient stay. Days 21 to 100 cost $214 a day in 2026 |
| Long-term custodial care | No | Help with bathing, dressing, and meals is not covered at any point. This is the largest gap in the program |
| Home health care | Yes, conditionally | Requires being homebound and needing skilled care |
| Hospice | Yes | Fully covered, including related equipment and medications |
| Prescription drugs | Through Part D | Not covered by A or B |
| Routine dental | No | Cleanings, fillings, extractions, dentures. Narrow exceptions when dental work is part of a covered medical procedure |
| Eyeglasses | No | One exception: a single pair after cataract surgery with a lens implant |
| Hearing aids | No | Diagnostic hearing exams ordered by your doctor are covered |
| CPAP machine and supplies | Yes | Rented for 13 months, then yours. A 90-day compliance rule applies |
| Wheelchairs and walkers | Yes | Durable medical equipment, 20 percent after the deductible |
| Hospital bed and oxygen | Yes | Same terms |
| Commode chair | Yes | With a doctor’s order for home use |
| Grab bars and walk-in tubs | No | Classified as home modifications |
| Shower chair | Generally no | Treated as a self-help item |
| Stair lift | No | Home modification |
| Lift chair | Partly | The lifting mechanism may be covered. The chair itself is not |
| Incontinence supplies | No | Considered personal hygiene products |
| Diabetes testing supplies | Yes | Meters and strips under Part B; insulin under Part D with a monthly cap |
| Weight loss medication | New in 2026 | The Medicare GLP-1 Bridge offers $50 monthly copays to qualifying Part D members through 2027 |
| Chiropractic care | Very limited | Manual spinal manipulation to correct a subluxation only. Not X-rays or exams |
| Acupuncture | Very limited | Chronic low back pain only, capped at 12 visits in 90 days |
| Routine foot care | No | Medically necessary podiatry is covered; trimming corns and calluses is not |
| Cosmetic surgery | No | Exceptions for reconstruction after injury or mastectomy |
| Care outside the United States | Rarely | Very narrow exceptions. Travel insurance is the usual answer |
The Detailed Guides
Each of these takes one question and answers it properly, including what to do when the answer is no.
Does Medicare Cover CPAP Machines and Supplies?
Yes, but with a condition most people are never told about. You have to use the machine at least four hours a night on 70 percent of nights in the first 90 days, or coverage can stop and the equipment can be reclaimed. The guide covers what you pay, the supply replacement schedule, and how to keep your coverage.
Does Medicare Cover Hearing Aids?
No, and it never has. Nearly all Advantage plans include some hearing benefit, and since 2022 there has been a regulated over-the-counter category that changed the economics entirely. The guide covers what Advantage plans actually pay and what the alternatives cost.
Does Medicare Cover Walk-In Tubs and Grab Bars?
No, because they are home modifications rather than equipment. The guide covers what Medicare does pay for in the bathroom, which other programs fill the gap, and the inexpensive changes that remove most of the fall risk.
Does Medicare Cover Power Wheel Chairs?
Yes, Part B covers power wheelchairs at 80 percent after the $283 deductible in 2026. But coverage is judged entirely on whether you can move around inside your own home. A chair you want for shopping, church, or travel will be denied, however much you need it.
What You Pay in 2026
- Part B standard premium: $202.90 a month, higher for higher incomes.
- Part B deductible: $283 for the year, then you pay 20 percent of most covered services.
- Skilled nursing facility: nothing for days 1 to 20, then $214 a day through day 100, then everything.
- Original Medicare has no annual out-of-pocket maximum. This is the reason most people carry either Medigap or an Advantage plan.
These figures reset every January. If you are reading this in a later year, check Medicare.gov for the current amounts.
Where to Get Free, Unbiased Help
Everyone selling Medicare plans has a commission attached. These sources do not.
- Your State Health Insurance Assistance Program, known as SHIP. Free one-to-one counseling from trained volunteers who cannot sell you anything. Every state has one.
- Medicare.gov, and the Plan Finder tool, which compares plans by your actual medication list rather than by advertising.
- 1-800-MEDICARE, which is slower than the website but useful for questions about a specific claim.
- Your Area Agency on Aging, which knows about local programs that no national website lists.
Frequently Asked Questions
What is the biggest thing Medicare does not cover?
Long-term custodial care. Help with bathing, dressing, eating, and supervision is not covered at any point, in any setting, regardless of how much you need it. Medicare covers skilled nursing for up to 100 days after a qualifying hospital stay, and that is the extent of it. This surprises more families than anything else in the program.
Why does Medicare cover a wheelchair but not a ramp?
Because equipment must not be useful to someone without an illness or injury. A wheelchair passes that test. A ramp does not, since anyone can walk up it, so it is classified as a home modification.
Does Medicare Advantage cover more than Original Medicare?
It must cover everything Original Medicare does, and most plans add dental, vision, hearing, and an over-the-counter allowance. In exchange you generally accept a provider network and prior authorization requirements. Neither choice is better in the abstract; it depends on your doctors and your health.
Can I get help paying my Medicare costs?
Possibly. Medicare Savings Programs help with premiums and cost sharing for people under certain income limits, and Extra Help does the same for Part D. Many who qualify never apply. A SHIP counselor can check your eligibility at no cost.
When can I change my coverage?
Open Enrollment runs October 15 through December 7 each year, with changes effective January 1. There is also a Medicare Advantage Open Enrollment period from January 1 to March 31 for people already in an Advantage plan.
The Short Version
Medicare is medical insurance, not a care program. It pays for treatment and for equipment that only a sick or injured person would use. It does not pay for the daily help, the household changes, or the routine care that make aging at home workable.
Knowing where that line falls is the whole game. It tells you what to ask your doctor to prescribe, what to look for in an Advantage plan, and what you will simply have to budget for yourself. The guides above work through the most common cases one at a time.
Related Reading
About the Author
Janice Tolj, MBA, is the founder of Healthy Essentials After 50. She spent more than 30 years as a corporate Controller in financial compliance, including federal grant compliance at Johns Hopkins University, and served as her mother’s personal and financial guardian, managing her Medicare coverage and prescriptions through years of care. She is not a physician or a licensed insurance agent, and she is not affiliated with Medicare or any insurer.
Disclaimer: this article is general education, not medical, insurance, or legal advice. Coverage rules and amounts change annually and vary by plan and region. Confirm your own situation with Medicare, your plan, or a SHIP counselor.