Does Medicare cover B12 shots?
Does Medicare cover B12 shots? Original Medicare will not unless it is medically necessary. Medicare Advantage plans may offer vitamin and supplement coverage as an added benefit, but you should contact your policyholder for details. Medicare Part D does not cover vitamins or minerals, but you may be able to request coverage with a plan utilization management plan. Read more below for details on Medicare supplement coverage.
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UPDATED: Jul 6, 2023
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UPDATED: Jul 6, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Original Medicare will generally not cover B12 shots or tablets unless they are medically necessary.
- Medicare Advantage plans may cover B12 shots and other supplements as an extra benefit, but you will need to refer to your policy for details.
- Medicare Part D does not cover vitamins and minerals, but you may be able to request coverage through a plan utilization management program.
Vitamin B12 has many benefits, including a boost in energy levels, help controlling weight, supporting brain function, and treating certain disorders. It can be taken orally or through an injection.
But does Medicare cover B12 shots? We’ll answer this question below and explore your coverage options under different Medicare health insurance plans.
If you need help finding the right health insurance rates for you, you can use our free insurance quote comparison tool above by entering your ZIP code. Which health insurance company is for you? Find out now.
Table of Contents
Does Medicare cover B12 shots?
If your doctor considers a B12 shot to be medically necessary, original Medicare may cover it. This could include use for some anemias, gastrointestinal disorders, neuropathies, or other disorders caused by a B12 deficiency.
Medicare Part B would cover B12 shots used for outpatient treatment, while Medicare Part A would cover B12 shots used for inpatient treatment (such as if you are hospitalized).
Medicare Advantage plans will vary, but they sometimes offer extra benefits, such as prescription drug coverage or help paying for over-the-counter vitamins and medicines. You should check with your policyholder to see if they will cover B12 shots or other supplements.
Medicare Part D will most likely not cover B12 injections or over-the-counter vitamins or minerals. However, if you happen to have B12 supplements listed on your Part D formulary (list of approved medications), they will be covered.
If Part D is not currently willing to cover B12 shots or supplements for you, you may be able to request a plan utilization management program. Medicare would then consider covering treatments that are not usually covered but are considered medically necessary for you.
If you do find coverage for your B12 shots, you may still have to pay some out-of-pocket expenses, including your premiums, deductible, and copayments or coinsurance.
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Case Studies: Medicare Coverage for B12 Shots – Analyzing Reimbursement and Patient Eligibility
Case Study 1: Medicare Coverage for B12 Shots – Patient Eligibility
Mrs. Johnson, a 70-year-old retiree, has been diagnosed with pernicious anemia and requires regular B12 shots for her treatment. She is enrolled in Medicare Part B and wants to know if Medicare covers the cost of B12 shots.
Under Medicare Part B, Mrs. Johnson is responsible for paying the annual deductible, which is subject to change each year, and the coinsurance or copayment for the B12 shots. The exact amount will depend on her specific plan and any supplementary insurance she may have.
It’s crucial for Mrs. Johnson to review her plan details and consult with her healthcare provider to understand her out-of-pocket costs.
Case Study 2: Medicare Coverage for B12 Shots – Frequency Limitations
Similar to Case Study 1, Mr. Davis would be responsible for the annual deductible, coinsurance, or copayment associated with B12 shots. The specific costs depend on his Medicare plan and any supplemental insurance coverage.
Case Study 3: Medicare Coverage for B12 Shots – Home Administration
Ms. Smith, a 65-year-old Medicare beneficiary, has been diagnosed with B12 deficiency and prefers to administer her B12 shots at home. She wants to know if Medicare covers the cost of home-administered B12 injections.
If Ms. Smith meets the eligibility requirements for home administration, Medicare would cover the cost of the B12 shots, including the medication itself. However, she would still be responsible for the applicable deductible, coinsurance, or copayment associated with the injections.
The Bottom Line
So, does Medicare cover vitamin B12 shots?
Medicare Part A and Part B will only cover B12 shots in certain circumstances if it is considered medically necessary. Medicare Advantage may cover B12 shots or offer help paying for over-the-counter supplements as an added benefit, but you will need to contact your policyholder for details.
Medicare Part D does not usually cover B12 shots or over-the-counter vitamins or minerals. However, if you are able to request a plan utilization management program, you may be approved for B12 shots as long as they are medically necessary.
Need help finding affordable health insurance? Before you buy health insurance, use our free tool below by entering your ZIP code to compare health insurance quotes from companies in your area.
Frequently Asked Questions
Does Medicare cover B12 shots?
Yes, Medicare Part B provides coverage for B12 shots when they are deemed medically necessary.
Can I appeal if Medicare denies coverage for B12 shots?
Yes, if Medicare denies coverage for B12 shots, you have the right to appeal the decision. You can follow the established appeals process to seek reconsideration of the denial.
Are B12 shots covered under Original Medicare?
Yes, B12 shots are covered under Original Medicare Part B, which provides coverage for medically necessary outpatient services and treatments.
Do I need a prescription for B12 shots to be covered by Medicare?
Yes, Medicare generally requires a prescription from your healthcare provider for B12 shots to be covered under Part B.
How much will I have to pay for B12 shots with Medicare coverage?
Under Medicare Part B, you will typically be responsible for paying the deductible, coinsurance, or copayment associated with the B12 shots, depending on your specific Medicare plan.
Can I get B12 shots covered under a Medicare Advantage plan?
Yes, Medicare Advantage plans (Part C) must provide at least the same level of coverage as Original Medicare. Therefore, if B12 shots are covered under Original Medicare, they should also be covered under Medicare Advantage plans.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
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Kristen Gryglik
Licensed Insurance Agent
Kristen is a licensed insurance agent working in the greater Boston area. She has over 20 years of experience counseling individuals and businesses on which insurance policies best fit their needs and budgets. She knows everyone has their own unique needs and circumstances, and she is passionate about counseling others on which policy is right for them. Licensed in Massachusetts, New Hampshire,...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.