Osteoporosis drugs

Medicare Part A (Hospital Insurance)  and Medicare Part B (Medical Insurance) help pay for an osteoporosis injectable drug 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 or caregivers are unable and unwilling to give you the drug by injection.

Your costs in Original Medicare

Your copay amount can change depending upon your prescription drug’s price. In most cases, after you meet the Part B deductible , you pay 0% to 20% of the Medicare-approved amount for the cost of the drug. 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
  • If 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 if, or how much, Medicare will pay for them.

Is my test, item, or service covered?