drugs 
Additional Benefits 
Medicare-covered foot care 
(podiatry) $25 copay 
Medicare-covered chiropractic 
services $20 copay 
Medical equipment/ supplies 
Cost share may vary depending 
on the service and where service 
is provided •Durable medical equipment (like wheelchairs or oxygen):  $0 copay 
or  20% of the cost 
•Medical supplies:  $0 copay 
•Prosthetics (artificial limbs or braces):  20% of the cost 
•Diabetic monitoring supplies:  $0 copay or  20% of the cost 
Rehabilitation services