You can visit any urologist accepting Medicare Part B, though some Medicare Advantage (Part C) plans might require a referral and an in-network provider. Medicare should cover most medically necessary urology care or supplies.

Urologists are doctors who treat both males and females with urinary and pelvic issues, as well as males with reproductive and genital concerns.

Read on to learn more about what Medicare covers for urology treatments and care.

Original Medicare is comprised of Medicare Part A (hospital insurance) and Medicare Part B (outpatient medical care). When you first enroll in Medicare, you’re eligible to have a “Welcome to Medicare” preventive visit, also called the Initial Preventive Physical Exam (IPPE). During this visit, your doctor will review your medical history and provide you with information about various preventive services.

This can include discussing any urological concerns. After this first visit, you’re also eligible for a similar annual wellness visit.

In addition, under Part B, you can generally see a urologist under Medicare Part B if the doctor accepts assignment. Some conditions that the doctor might diagnose include:

  • cancers (bladder, kidneys, penis, testicles, adrenal, prostate)
  • prostate enlargement
  • erectile dysfunction
  • kidney diseases and stones
  • prostatitis
  • urinary tract infections (UTIs)
  • bladder prolapse
  • interstitial cystitis
  • overactive bladder
  • urinary incontinence

Does Medicare require a referral to a urologist?

Original Medicare does not require a referral to see a specialist doctor. But you might be required to get a referral if you’re enrolled in a Medicare Advantage (Part C) plan.

Under Part C, you can get the same physician consultations as you would under Original Medicare. That said, Part C plans are managed privately, and there are five types of Part C plans:

Usually, HMO plans require you to see a primary care doctor first and get a referral for a specialist, such as a urologist. You’ll also have to see a doctor within the plan’s network. Many SNP plans might also work as HMOs. Alternatively, PPO plans generally don’t have these requirements.

Beyond seeing a urologist, Medicare should cover most urology-related medical services and supplies needed in hospitals, doctors’ offices, and other healthcare settings if it’s medically necessary. In addition to physician check-ups, these may include:

  • screenings such as the prostate cancer screening
  • diagnostic tests such as a urine culture
  • outpatient and inpatient procedures or surgeries
  • certain urological supplies such as catheters
  • prescription medications

Urological supplies covered as prosthetic devices under Medicare include urinary catheters and external urinary collection devices. These products are covered when they are needed to treat permanent urinary incontinence or retention. Coverage usually includes miscellaneous supplies, but only those that you would need when using a catheter.

In addition, if you are hospitalized for a urological condition, your coverage will fall under Part A. Under Part C, you should get the same coverage as you would under Original Medicare.

Prescription medications that you might need to treat a urological condition would generally fall under the coverage of Medicare Part D or Medicare Advantage prescription drug (MAPD) plans. However, which specific drugs are covered depends on the specific plan.

The only exception is medications you cannot administer yourself, such as intravenous (IV) chemotherapy drugs. In this case, coverage falls under Part B.

Part B fully covers both the “Welcome to Medicare” and the annual wellness visit. In 2025, once you’ve met the Part B deductible of $257, Part B will cover 80% of the cost for any other doctor’s visits, treatments, or services. You also need to pay a monthly premium, which starts at $185, depending on your income.

For Part A, most people aren’t required to pay a premium, but there is a $1,676 deductible you need to meet for coverage. After meeting the deductible, Part A will cover your hospital stay, the procedure you’re undergoing, and any necessary care during that time for the first 60 days. Afterward, an additional daily fee begins to apply.

With Medicare Part D, your out-of-pocket costs depend on how covered drugs are classified within your plan’s formulary. Since Part D plans are managed by private companies, each one sets its own premiums and deductibles.

Part C plans are also managed by private insurers and vary in premiums, deductibles, and coinsurance based on the specific plan. Additionally, enrolling in a Part C plan requires you to continue paying the Part B premium, though some Part C plans might cover this cost.

Who is eligible to see a urologist with Medicare?

You’re eligible to see a urologist with Medicare if you have Medicare coverage. You can enroll in Medicare at the age of 65 or sooner if you live with certain conditions or receive disability benefits from Social Security.

Where do I find a urologist who accepts Medicare near me?

You can find urologists who accept assignment in your area by searching the database on the Medicare.gov website.

If you are enrolled in Part C instead of Original Medicare, check whether you must see a doctor in your plan’s network. If yes, you should be able to find which doctors are in the network within your plan account online or by calling your insurance provider.

Urologists are medical specialists who evaluate and treat urinary and pelvic problems, as well as male reproductive and genital issues.

You can see any urologist who accepts Medicare Part B. But certain Medicare Advantage (Part C) plans may ask you to get a referral from a primary care doctor and choose a provider within their network.

In addition, Medicare generally covers most medically necessary urology diagnostic services and treatments.