Does Medicare Advantage Cover Telehealth, GLP-1s, Dental and More?

Medicare Advantage plans must cover all the medically necessary services Original Medicare covers, including telehealth. Most plans also include Part D drug coverage. GLP-1 drugs for weight loss alone aren't covered, but if you qualify, the GLP-1 Bridge offers some for $50 a month. Dental, hearing and vision are extras many plans add. What's covered and what you pay vary by plan, so check your plan's Evidence of Coverage (the document that lists what it covers and what you pay).

Plans also set their own rules for getting care, such as a network, referrals or prior authorization (the plan's approval before it pays).

Does Medicare Advantage cover prescription drugs?

Most plans do. They include Part D drug coverage. In most types of plans, you can't add a stand-alone drug plan. If yours has no drug coverage, you'll usually need a different plan to get it. Each plan's drug list, called a formulary, sets which drugs it covers and their tiers.

Once you've paid $2,400 out of pocket for covered drugs, you pay $0 for them for the rest of 2027. Premiums and drugs that aren't on your plan's drug list don't count toward the cap. See Medicare Part D in 2027.

Does Medicare Advantage cover telehealth?

Yes. Plans cover at least the telehealth Original Medicare covers, and some plans add more. Through December 31, 2027, Medicare covers telehealth from anywhere in the U.S., including your home. Coverage for mental health visits from home is permanent. Our full telehealth answer explains what's covered and what you pay.

Does Medicare Advantage cover GLP-1 drugs for weight loss?

Not for weight loss alone. By law, Medicare drug coverage, including a Medicare Advantage plan's, can't pay for drugs used only for weight loss.

The Medicare GLP-1 Bridge is a temporary program outside your plan's drug benefit. From July 1, 2026, through December 31, 2027, people who qualify pay $50 for a one-month supply of Wegovy, Foundayo or Zepbound KwikPen.

To qualify, you need Medicare drug coverage (a Medicare Advantage plan with drug coverage counts). You also need to meet the program's BMI criteria and get prior authorization. The $50 doesn't count toward the Part D out-of-pocket cap.

People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease can't use the Bridge. Their plan may cover a GLP-1 for those conditions instead. See our guide to the Medicare GLP-1 Bridge. A licensed doctor on Doctronic can review the criteria with you by video and prescribe if appropriate: see weight loss treatment on Doctronic.

Does Medicare Advantage cover Wegovy?

It depends on why you take it. For weight loss, Wegovy is in the GLP-1 Bridge, as an injection or a tablet, at $50 a month if you qualify.

Wegovy is also FDA-approved to lower the risk of heart attack, stroke and death from heart disease in adults with heart disease and obesity or overweight. For that use, your plan's drug coverage may cover it now, possibly with prior authorization.

From January 1, 2027, Wegovy, Ozempic and Rybelsus (all semaglutide) share a Medicare negotiated price of $274 for a 30-day supply, down from a $959 list price in 2024. That's what Medicare drug plans pay, not your copay. The exact price depends on the form and dose.

Does Medicare Advantage cover Zepbound?

Not for weight loss, but one form is in the GLP-1 Bridge. If you qualify and have a Medicare Advantage plan with drug coverage, Zepbound KwikPen costs $50 a month through the Bridge. Zepbound vials and single-dose pens aren't in the Bridge, so check the form on your prescription.

Zepbound is also approved for moderate to severe obstructive sleep apnea in adults with obesity. That coverage follows your plan's own rules (see Zepbound for sleep apnea). Our guide to Zepbound and Medicare has the rest.

Does Medicare Advantage cover Ozempic?

Yes, for type 2 diabetes, if your plan includes drug coverage. Part D doesn't pay for Ozempic used for weight loss, and Ozempic isn't in the GLP-1 Bridge.

Many plans need prior authorization, and some use step therapy (trying a lower-cost drug first). From January 1, 2027, Medicare's negotiated price for Ozempic is $274 for a 30-day supply, as for Wegovy. Our guide to Ozempic and Medicare covers what you might pay.

Does Medicare Advantage cover home health care?

Yes, the home health care Original Medicare covers: part-time or intermittent skilled nursing or therapy at home, from a Medicare-certified agency. It's covered when both of these are true:

• You're homebound: you normally can't leave home without a lot of effort, and leaving isn't recommended because of your condition.

• A doctor or other provider sees you in person and orders care at home.

A home health aide is covered only when you also get skilled care. 24-hour care, meals and housekeeping aren't covered. In Original Medicare, you pay nothing for covered home health services.

A plan's home visits for a health check are a separate benefit, not home health care.

Does Medicare Advantage cover nursing homes?

For short skilled nursing stays, yes. For long-term custodial care, no.

Original Medicare covers up to 100 days of skilled nursing facility care in each benefit period. Coverage follows a medically necessary inpatient hospital stay of at least 3 days in a row. Time under observation or in the emergency room doesn't count.

Days 1 to 20 cost $0 once you've paid the Part A deductible ($1,736 in 2026). A plan may charge copays during the first 20 days, or waive the 3-day hospital stay rule.

Custodial care is help with everyday tasks, like dressing and bathing, and Medicare doesn't pay for it in a nursing home. Medicaid may cover long-term care, including in a nursing home, if you meet your state's eligibility rules.

Does Medicare Advantage cover physical therapy?

Yes, when it's medically necessary. Part B covers outpatient physical therapy when a doctor or other qualified provider certifies that you need it, with no yearly limit. In Original Medicare, you pay 20% of the Medicare-approved amount after the Part B deductible.

Through December 31, 2027, physical therapists can also give Medicare-covered care by telehealth, including at your home.

Does Medicare Advantage cover cataract surgery?

Usually, yes. Part B may cover cataract surgery that implants a standard intraocular lens (the artificial lens that replaces the cloudy one), depending on where you live. In Original Medicare, you pay 20% of the Medicare-approved amount for the surgery, after the Part B deductible.

After each cataract surgery that implants an intraocular lens, Medicare covers one pair of eyeglasses with standard frames or one set of contact lenses, from a supplier that participates in Medicare.

Does Medicare Advantage cover eye exams?

For medical eye care, yes. Routine exams for glasses depend on your plan's vision benefit.

• Diabetic eye exam: covered once a year if you have diabetes.

• Glaucoma test: covered once every 12 months if you're at high risk, for example if you have diabetes or a family history of glaucoma.

• Routine exam for glasses or contacts: Original Medicare doesn't cover it.

In 2026, more than 99% of people in individual Medicare Advantage plans (not employer or special needs plans) were in a plan that offers eye exams, glasses or both, KFF found.

Does Medicare Advantage cover dental?

Often, as an extra benefit. In most cases, Original Medicare doesn't cover cleanings, fillings, extractions, dentures or implants. It may cover dental care another covered treatment needs, such as an oral exam before a heart valve replacement or an organ transplant.

In 2026, 98% of people in individual plans were in a plan that offers some dental care, KFF found. That can mean anything from cleanings and X-rays only to crowns or dentures. Look for:

• A yearly dollar cap on what the plan pays

• How often each service is covered

• A network of dentists you must use

• Prior authorization, which may be needed even for cleanings

Many plans are reducing extra benefits like dental for 2027; check your Annual Notice of Change. CMS has said it expects extra benefits to stay stable overall, so check your own plan's notice. See what's changing in Medicare Advantage for 2027.

Does Medicare Advantage cover hearing aids?

Many plans do, as an extra benefit. Original Medicare doesn't cover hearing aids or the exams to fit them. It covers diagnostic hearing and balance exams your doctor or another provider orders.

In 2026, 95% of people in individual plans were in a plan that offers hearing exams, hearing aids or both, KFF found. That counts exams and aids together, so a plan may not cover the aids themselves. Check whether yours covers the aids, and any dollar limit per ear or per pair.

How to check your plan

1. Search your plan's Evidence of Coverage for the service you need.

2. Note the copay and any referral, prior authorization or network rule.

3. Read your Annual Notice of Change (the letter your plan sends each fall listing next year's changes) for what changes in 2027.

Our guide to what Medicare Advantage covers explains the rest of your coverage. If something isn't clear, call member services. Doctronic isn't a licensed insurance agent or broker and doesn't recommend plans. For free help comparing plans, use Medicare.gov, call 1-800-MEDICARE or contact your State Health Insurance Assistance Program (SHIP).

Running low on a medicine while you sort out a plan change? A renewal (a new prescription for a medicine you already take) doesn't have to cost you a morning off for an office visit. A licensed doctor is available by video, and Doctronic accepts Medicare.