What You Can Look Up on Medicare.gov
You can check your current Medicare coverage, see what doctors and hospitals are in your plan, and look up what prescription drugs are covered — all without calling anyone. The official Medicare website at Medicare.gov has a tool called "Find Care Providers" that shows you in-network doctors, and another called "Find Prescription Drug Coverage" that lists which medications your plan covers and what you pay.
You can also view your claims history, check your deductible status, and see what services you have already used in the current year. If you have Original Medicare (Part A and Part B), you can see which hospitals and doctors accept Medicare. If you have a Medicare Advantage plan or a Medigap policy, the coverage details are different — your plan's own website usually has more detail than Medicare.gov does.
The tools work best when you know your Medicare number (on your red, white, and blue Medicare card) and your ZIP code. You do not need to log in to search for doctors or drugs, but you will need to create a Medicare.gov account to see your personal claims and coverage details.
Key Takeaways
- Medicare.gov has free search tools for doctors, hospitals, and prescription drugs that work without logging in.
- To see your own claims history and deductible status, you must create a free Medicare.gov account using your email and Medicare number.
- Medicare Advantage and Medigap plans have their own websites where you can often find more detailed coverage information than Medicare.gov shows.
- If you cannot find what you need online, you can call Medicare directly at 1-800-MEDICARE (1-800-633-4227) and speak to someone who can look up your specific coverage.
Creating Your Medicare.gov Account
To see your personal coverage details and claims, you need a free account on Medicare.gov. Go to the homepage and click "Sign In" in the top right corner. You will see an option to create a new account — choose that instead of trying to log in.
You will need your email address, a password you create, and your Medicare number (the 11-digit number on your Medicare card, not your Social Security number). Medicare will send you a confirmation email — click the link in that email to finish setting up your account. The whole process takes about five minutes.
Once you are logged in, go to "My Health Care" and then "Coverage" to see what services you have used, what your deductible is, and how much you have paid toward it so far. You can also see upcoming preventive services you are may have access to to at no cost.
Searching for Doctors and Hospitals in Your Plan
On Medicare.gov, click "Find Care Providers" without logging in. Enter your ZIP code and choose whether you are looking for a doctor, hospital, or other provider. The search shows you which providers in your area accept Medicare and, if you have a Medicare Advantage plan, whether they are in your plan's network.
The search results show the provider's address, phone number, and whether they are currently taking new patients (though this information is not always current). If you have a Medicare Advantage plan, the results will tell you if the provider is in-network or out-of-network — in-network providers cost you less.
If you do not see a doctor you want to use, call the doctor's office directly and ask if they accept your specific Medicare plan. The online tool is not always up to date, and some doctors accept Medicare but are not listed.
Looking Up Prescription Drug Coverage
Click "Find Prescription Drug Coverage" on Medicare.gov. Enter the name of each drug you take, your ZIP code, and the pharmacy where you fill prescriptions. The tool shows you which Medicare plans cover that drug and what you will pay — the copay, coinsurance, or deductible.
Drug coverage changes every year on January 1st, so if you are checking in the fall, you are looking at next year's coverage. The tool also shows you whether the drug is on the plan's formulary (the official list of covered drugs) or whether you need prior authorization from the plan before the pharmacy will fill it.
If a drug is not covered, the tool shows you which plans do cover it. You can compare plans side by side to see which one covers the most of your medications at the lowest cost. If you take many drugs, this comparison can save you hundreds of dollars a year.
Checking Your Claims and Deductible Status
Log into your Medicare.gov account and go to "My Health Care," then "Claims." You will see a list of all the claims Medicare has processed for you, including the date of service, what was billed, what Medicare paid, and what you owe. You can read or print individual claims or a summary of all claims from a date range.
In the same section, you can see your deductible status for the current year. For Original Medicare Part B, this shows how much of your $240 deductible (the amount varies by year) you have already met. For Part A, it shows whether you have used any of your hospital benefit days. If you have a Medicare Advantage plan, your deductible and out-of-pocket maximum are shown on your plan's website, not on Medicare.gov.
Claims usually appear online within a few days of being processed. If you see a claim you do not recognize or think is wrong, you can file an appeal through your Medicare account or by calling 1-800-MEDICARE.
Understanding Your Plan's Own Website
If you have a Medicare Advantage plan (like Humana, United, or Aetna) or a Medigap policy, your plan's own website often has more detail than Medicare.gov. Log into your plan's member portal using your member ID (on your insurance card) and look for sections labeled "Coverage," "Benefits," or "My Plan."
Your plan's website shows your specific copays, coinsurance amounts, and deductibles. It also lists which doctors and hospitals are in your network and which drugs are covered. Some plans let you check your claims and deductible status on their site before the information reaches Medicare.gov.
If you cannot find what you need on your plan's website, call the customer service number on the back of your insurance card. They can tell you exactly what a specific service will cost and whether you need prior authorization.
What to Do If You Cannot Find the Information Online
If the online tools do not answer your question, call Medicare directly at 1-800-MEDICARE (1-800-633-4227). The line is open 24 hours a day, 7 days a week. Have your Medicare number and your insurance card ready. A representative can look up your coverage, tell you whether a specific doctor is in your plan, and explain what a service will cost.
If you have a Medicare Advantage or Medigap plan, calling your plan's customer service number (on your card) is often faster than calling Medicare, because they have access to your specific plan details. Wait times are usually shorter in the early morning or late afternoon on weekdays.
You can also visit a local Social Security office or a State Health Insurance information Program (SHIP) office in person. SHIP offices are free and can help you understand your coverage and answer questions about your plan. Find your local SHIP office at shiptalk.org.
Frequently Asked Questions
Do I need to log in to search for doctors and drugs?
No. The "Find Care Providers" and "Find Prescription Drug Coverage" tools work without logging in. You only need to log in to see your personal claims, deductible status, and coverage details.
Why does the online tool show a doctor as in-network when my plan says they are not?
The Medicare.gov database is not always current. Call your plan's customer service number to confirm whether a specific doctor is in-network before you make an appointment. Your plan has the most accurate information.
Can I check my coverage on my phone?
Yes. Medicare.gov works on phones and tablets. You can also read the official Medicare mobile app from the Apple App Store or Google Play to search for doctors and drugs on the go.
What if I forgot my Medicare number?
You can create a Medicare.gov account using your email and Social Security number instead of your Medicare number. Medicare will look up your number in the system. You can also call 1-800-MEDICARE to get your number.
How often does the coverage information update?
Drug coverage and plan networks update daily on Medicare.gov. Your personal claims and deductible status update within a few days of being processed. Plan-specific information on your insurance company's website may update faster.