Does Medicare Cover Nebulizers? 

Although many medications work best when taken orally in the form of a pill, others work best when injected. Still, others work best when converted from a liquid into an aerosol to be inhaled. In this latter case, a nebulizer is used to make the conversion. Nebulizers are used for medications when the most effective route for administration is to inhale the medication.

Inhalation often gets medications into the bloodstream faster. Additionally, some medications need to be applied directly to lung tissue. An example of this may be a steroidal inhaler medication for dealing with an emergency asthma attack. Nebulizers are typically used at home or in a doctor’s office, and they work by atomizing liquid. Portable nebulizers are available, but they may not be efficient for all cases.

Who needs nebulizers?

Pediatric patients often require the use of a nebulizer due to the inability to take medications in other ways. A newborn may require the use of a nebulizer to treat a respiratory condition, and toddlers also commonly use nebulizers.

Despite this, seniors can also benefit from the use of nebulizers. Seniors sometimes have trouble taking certain medications, and a nebulizer can help to get medications working faster.

Does Medicare cover nebulizers?

Seniors fall into a group that often needs the use of nebulizers, but does Medicare cover the cost of renting or purchasing a nebulizer? Although each plan is different, Original Medicare benefits apply toward the cost of renting or purchasing a nebulizer as long as certain conditions are met.

Any type of Medicare coverage requires that a piece of equipment or a medical treatment be deemed medically necessary. This means that your doctor will need to prescribe the use of a nebulizer in order for the equipment to be considered for coverage. Next, Medicare covers durable medical equipment (DME) through Medicare Part B. In order for Medicare coverage under Part B to apply toward the procurement of a nebulizer, the equipment must come from a Medicare-enrolled supplier. If you purchase a nebulizer on your own, you may be responsible for the full cost.

Under Part B, Medicare insurance covers 80% of the cost of DME. The remaining 20% is covered by Medicare recipients, but you must also have met your deductible for the year and be current on your plan premium. Medicare Supplement Insurance (Medigap) may help to offset your coinsurance costs if you have purchased one.

Does Medicare cover the cost of nebulizer medications?

Medicare may also cover the cost of prescription medications that are used in nebulizers. In order for these costs to be covered by Medicare insurance, you must carry Medicare Part D.

This is prescription drug coverage, and it is used to cover the cost of prescriptions that are self-administered and available from retail pharmacies. If you are provided with a dose of medication while at a doctor’s office, Medicare Part B supplies coverage instead. If you are required to use a nebulizer while admitted to a hospital or skilled nursing facility, Medicare benefits under Part A apply.

Does Medicare Advantage cover nebulizers?

Medicare recipients who have Medicare Advantage as opposed to Original Medicare coverage can also receive benefits for nebulizer purchases or rentals. Through a Medicare Advantage plan, you’ll have at least the same coverage as Original Medicare, but plans may supply additional coverage.

A Medicare Advantage plan may provide a network of suppliers from which to rent or purchase equipment. You may also receive additional benefits for fitness classes designed to improve respiratory conditions. Each plan and provider are different, so you’re encouraged to work with an independent Medicare insurance broker who can help you shop plans from different providers to find the one that works best for your needs.