Fortunately, Medicare feels that bone health is essential and can help you get excellent bone care, whether it be testing or treatment. There are about 10 million people in the United States alone with Osteoporosis and almost 34 million more with low bone mass.
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Medicare Coverage of Bone Mass Density Tests
Your Part B benefits cover a dense bone measurement every two years; unless you need more because it’s essential.
It’s necessary if you meet a minimum of one of the following conditions:
- X-rays show the potential of osteoporosis, fractures, or osteopenia.
- You’re on prednisone or other steroid medications
- You’re a female, and your doctor has deemed you as estrogen-deficient.
- You have hyperparathyroidism
If you’ve fractured your bone, had a loss in height, had a drop in hormone levels, or have used steroids over a long period of time, your doctor may order a bone density test. As long as your doctor accepts Medicare Assignment, you will pay nothing out of pocket for this test with Original Medicare.
Who’s Commonly Affected by Osteoporosis?
While both women and men can be affected by osteoporosis, this common ailment typically affects women. One-third of fractures of the hips are found in men, while women make up about two-thirds of hip fractures around the world.
This condition usually peaks in people over the age of 50 years old. Several things commonly come into play with individuals who are affected by osteoporosis.
Some of the most significant fundamental factors are:
- Gender and Race – Caucasian and Asian women with small body frames tend to have a higher chance of facing this condition.
- Habits – Studies show that people using an excess of alcohol, cigarette smoking, lack of calcium, infrequent exercise, and heavy caffeine intake can lead to the onset of osteoporosis.
- General Health – If a person deals with poor health and lack of nutrition, they may find themselves more susceptible to osteoporosis.
- Hormones – Menopause or a hysterectomy can cause osteoporosis because of lower estrogen levels.
- Chronic Conditions – Several chronic conditions can negatively impact your bones, like Rheumatoid Arthritis or Hepatitis C.
Does Medicare Cover Prolia?
A typical prescription medication used in the treatment of osteoporosis is Prolia. Prolia is an injectable medication. Medicare will cover Prolia injections once every six months.
How to Get Help Covering the Cost of Bone Density Testing Under Medicare
Medicare Supplement plans fill in the gaps by covering the 20% you would otherwise pay under Part B. By relieving you of this cost, you can worry less about bills and more about recovery. The best part about a supplement is that when Medicare approves a service, the supplement must authorize the service as well. Knowing this gives many beneficiaries peace of mind.
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If you think you’d benefit from supplemental coverage, give us a call. We’ll take the time to provide you with the information to compare as well as select the right plan. Also, if you have a plan and want to find a lower premium, contact us today! If you don’t feel like calling in now, compare rates online!
If I was diagnosed with osteoporosis but am taking Fosamax and haven’t had any further collapsed vertebrae in the past several years, would I be able to pass medical underwriting to change medigap plans? What if I am taking coumadin for a deep vein thrombosis?
Hi Dixie! This really depends on your location and the carriers available in your area. Some carriers have more declinable pre-existing conditions than others. Give us a call and we can help compare what options you have to switch Medigap plans.