Osteoporosis drugs

Your Medicare Coverage

Is my test, item, or service covered?

Osteoporosis drugs

 and 

 help pay for an injectable drug for osteoporosis and visits by a home health nurse to inject the drug if you meet these conditions:

  • You’re a woman.
  • You’re eligible for Part B and meet the criteria for Medicare home health services.
  • You have a bone fracture that a doctor certifies is related to postmenopausal osteoporosis.
  • Your doctor certifies that you’re unable to learn to give yourself the drug by injection and your family members and/or caregivers are unable and unwilling to give you the drug by injection.
How often is it covered?
Your costs in Original Medicare

You pay 20% of the 

 for the cost of the drug, and the Part B 

 applies. You pay nothing for the home health nurse visit to inject the drug.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

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. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

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