Your Medicare Coverage

Is my test, item, or service covered?

Osteoporosis drugs for women

How often is it covered?

Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) help pay for an injectable drug for osteoporosis in certain women. Medicare also covers the visit by a home health nurse to inject the drug.

Who's eligible?

Women with Medicare are covered if they:

  • Are eligible for Part B
  • Meet the criteria for Medicare home health services
  • Have a bone fracture that a doctor certifies was related to post-menopausal osteoporosis
  • Are certified by a doctor as unable to learn to give themselves the drug by injection, and family and/or caregivers are unable or unwilling to give you the drug by injection

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the cost of the drug, and the Part B deductible applies. You pay nothing for the home health nurse visit to inject the drug.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

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