Does Medicare Cover B12 Shots?
Vitamin B12, cobalamin, is a water-soluble vitamin essential for your central nervous system, red blood cells and DNA synthesis. Generally, a balanced diet provides the amount of vitamin B12 your body needs, but proponents of vitamin B12 supplements tout the boost in health benefits. Cyanocobalamin is the name of the synthetic pharmaceutical version.
The National Center for Health Statistics conducted a survey showing that 12.4% of adults take vitamin B12 supplements. Your doctor may recommend vitamin B12 injections if you have a deficiency since intramuscular shots can bypass absorption barriers.
Vitamin B12 requirements
The Recommended Dietary Allowance (RDA) of vitamin B12 for most adults is 2.4 mcg. According to The National Institutes of Health (NIH), this is an attainable level for most people in the United States. Food sources of vitamin B12 include meat, poultry, fish, nuts, eggs and dairy products.
The NIH reports that most Americans consume sufficient levels of vitamin B12. Older adults may be at risk of deficiency due to age-related changes in body chemistry that interfere with the body’s ability to absorb vitamin B12. Specific health conditions contribute to malabsorption as well.
Medicare coverage for vitamin B12 injections
The Social Security Act states that Medicare will not pay for any services or supplies not reasonable or necessary to diagnose or treat an illness or injury. Original Medicare does not cover over-the-counter supplements or routine tests for nutritional deficiencies. However, there are specific circumstances when Medicare may recognize vitamin B12 injections as medically reasonable and necessary.
For instance, suppose you have a medical condition known to cause a specific vitamin deficiency or present symptoms indicative of such a deficiency. Medicare may cover the cost of a laboratory test prompted by clinical findings. Patients with a history of low serum B12 or conditions resulting in or causing a deficiency may be eligible for vitamin B12 injections.
Coverage may apply if you:
- Undergo specific types of chemotherapy treatments
- Have dietary vitamin B12-deficiency anemia
- Chronic pancreatitis
- Intestinal malabsorption
Medicare benefits for testing and drugs
Part B covers medically necessary laboratory tests, such as blood tests and urinalysis, required for doctors to confirm a clinical diagnosis. If you use a Medicare-participating provider, you incur no cost for the service. Part B also covers injections your doctor administers in an outpatient office setting. You are responsible for the Part B deductible and 20% of the approved Medicare charges.
If you have Medicare Advantage, refer to your provider directory for healthcare practitioners and facilities in your plan’s network.
Medicare Advantage coverage for supplements
Most Medicare Advantage plans include extra benefits that go beyond Original Medicare coverage. If you are a Medicare Advantage member, check your Evidence of Coverage to see if your plan covers over-the-counter products. If this benefit is available, you may be eligible for an allowance to purchase vitamin B12 supplements from the plan’s contracted supplier.
Resources for additional information
The supplement industry heavily markets to the public, so follow the guidance of a qualified healthcare practitioner familiar with your health status and history. Talk to your doctor, and use credible resources to research the benefits, risks, food sources and conditions leading to vitamin deficiency. The NIH Office of Dietary Supplements, National Library of Medicine MedlinePlus and Mayo Clinic offer online information you can explore.