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Does Medicare Cover Anemia


Medicare covers anemia, but the costs depend on treatment, and if you have supplemental coverage. Below we’re going to discuss everything you need to know about how Medicare covers anemia. When you finish this article, you’ll be an expert!

Will Medicare Cover Anemia Treatment?

Part A covers therapy during a hospital stay. Coverage may include services such as blood transfusions, medications, injections, and surgeries. Part B covers doctor visits and specific treatments. Also, outpatient drugs fall under Part B. Further, Part B may pay for B-12 or iron injections that you obtain from your doctor. With Medicare, deductibles and coinsurances apply. Medigap can help cover these costs.

Medicare Outpatient Infusion Therapy Coverage

Section 5012 of the 21st Century Cures Act established a new Medicare home infusion therapy benefit. The infusion therapy benefit is for coverage on home infusion therapy- associated professional services for medications and biologicals given intravenously, or subcutaneously through a pump that is Durable Medical Equipment. The act goes into effect on January 1, 2021.

Medicare Home Infusion Therapy Coverage Act

The Preserving Patient Access to Home Infusion Act is new legislation that gives patients access to Part B home infusion medications. The main goal of the Act is to ensure patients with Medicare access under the Part B Durable Medical Equipment benefit. The recent outbreak puts emphasis on the value of home-based treatments for vulnerable patients.

How Much Does it Cost to Treat Anemia?

The cost of therapy varies because there are many causes. Anemia treatments range from iron supplementation, observation, surgery, medications, or sometimes cancer treatment.

One of the most expensive anemia injections can cost upwards of $1,500 per vial. Private insurance companies may charge more. You can always talk to your doctor about a cheaper alternative.

Medicare Advantage Coverage for Anemia

Part C must cover at least as good as Medicare. It’s likely that with a Part C policy you’ll pay a copayment when you go to the doctors or specialists. Further, if you have an anemia complication that lands you in the hospital for a long period of time, your costs could be unbearable. You’re likely not covered out of network with an Advantage plan. So, if you have severe anemia it could benefit you to have a Medicare Supplement.

Medicare Part D Drugs for Anemia

Some stand-alone Part D or Advantage plans may cover the cost of anemia drugs. Medicare doesn’t pay for drugs. Before you enroll in a plan, check that your specific medication is on the formulary.

FAQs

Does Medicare cover B12 shots for anemia patients?
Coverage for B-12 shots may be available for those with pernicious anemia due to a B-12 deficiency. But, you may only get shots once a month. Doses may range from 100 – 1000 micrograms. In the acute phase of the condition, more frequent shots may be necessary. Medicare may cover the costs until the disease becomes manageable.
Does Medicare cover iron infusions for anemia patients?
You may need an IV infusion if you can’t take the supplements orally or absorb the iron through the gut. Patients who suffer from blood loss may also need an IV iron shot. Medicare covers iron infusions after oral supplements don’t work. If chronic kidney disease causes anemia, IV fusions have coverage.
Does Medicare cover blood transfusions?
You can always have blood donated to you. Medicare would cover inpatient and outpatient blood transfusions. You may incur some costs.

How to Get Medicare Coverage for Anemia

Did you know that Medicare Supplements fill the "gaps" of Medicare? Well, this is the first recommendation of many agents. Let me tell you why. See, instead of paying copayments and coinsurances, you have a steady premium every month.

Having any chronic conditions can be costly. With a Medigap plan, you can easily budget healthcare costs. We can help you find the best plan for your needs. As Medicare experts, we answer questions and walk you through the process.

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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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