Original Medicare covers your anemia diagnosis and treatment. Specific benefits can vary depending on your coverage. Your doctor must state that the tests or treatments are medically necessary for Medicare coverage to kick in.
The content below will cover everything you need to understand about Medicare coverage for anemia.
How does Medicare cover anemia?
Part A covers inpatient tests and treatments. However, most diagnostic tests will take place in an outpatient setting. Medicare Part B covers this testing.
Medicare covers additional tests your doctor may order to verify your diagnosis. Part B will also cover treatments such as B12 injections, ESA injections, iron infusions, and blood transfusions. Other treatments depend on your situation.
Intravenous iron therapy that takes place in a doctor’s office as an outpatient has coverage through Part B. Medicare’s National Coverage Determination (NCD) says IV iron therapy is a standard treatment for those with End-Stage Renal Disease (ESRD) undergoing hemodialysis.
Do Medicare Advantage plans cover anemia?
Medicare Advantage plans provide additional coverage beyond what traditional Medicare covers. You can expect a Part C plan to include Part D coverage, dental, vision, hearing, and more.
Part C plans have copayments and coinsurance costs, just like standard Medicare. Any services you need will also require medical necessity, just like Medicare.
Do Medicare supplements cover anemia?
Medigap plans fill the gaps in Medicare by paying for services and procedures you’d otherwise pay, such as the Part A deductible or the Part B coinsurance. Another benefit to this type of plan is the freedom to see any doctor nationwide and use your coverage as if you’re home.
Medicare Supplemental plans can provide you with predictability regarding your healthcare.
Does Medicare Part D cover anemia?
A Part D drug plan is beneficial because some medications, such as iron supplements, folic acid, or vitamin supplements, won’t have coverage through Original Medicare.
Other prescription drugs your doctor prescribes for you to take at home, such as ferric carboxymaltose, will have coverage through Part D. Working with a licensed insurance agent is the easiest way to find the Part D policy that saves you the most money.
Is ferrous sulfate covered under Part D drug plans?
No, most Medicare Part D drug plans don’t cover this medication. You can talk to your doctor about potential alternatives.
Does Medicare cover blood tests for iron deficiency anemia?
Yes, Medicare will cover blood testing for iron deficiency anemia. The blood test is usually called a complete blood count (CBC). Talk to your doctor for medical advice.
Does Medicare cover intravenous iron therapy?
Yes, Medicare covers iron sucrose injections for treating iron deficiency intravenously. Beneficiaries with chronic hemodialysis and receiving erythropoietin therapy can receive intravenous iron therapy.
Does Medicare cover hemoglobin blood tests?
Yes, Medicare covers a blood test ordered by a doctor as long as the test is done to diagnose, treat, or monitor.
Does Medicare cover an iron infusion?
Medicare covers iron infusions if oral supplements don’t work. Beneficiaries suffering from blood loss may also need an IV iron shot.
How can I get help finding additional Medicare coverage for anemia?
Those with any anemia will benefit from having additional insurance. Whether you choose a Medigap plan that can eliminate some of your out-of-pocket costs or a Part C plan that rolls all your benefits into one, having that coverage can be essential for your health.
Our licensed insurance agents can help you compare your plan options over the phone.
To discuss your options, give us a call today. You can also fill out an online rate form to receive the best options available in your area.