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Does Medicare Cover Antibiotics?

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What are antibiotics?

Antibiotics are medications that kill bacteria in the body. Doctors may prescribe antibiotics to treat bacterial infections, according to the National Institutes of Health.

Antibiotics: what kinds of infections are they used to treat?

According to the Centers for Disease Control and Prevention (CDC), doctors might prescribe antibiotics to help treat:

  • Strep throat
  • Urinary tract infections
  • Some kinds of pneumonia
  • Sepsis
  • Giardia (an infection caused by parasites in untreated water)
  • Sexually transmitted diseases (STDs), according to the National Institutes of Health
  • Staph infections (staphylococcus aureus)
  • Cholera

These are just a few examples of the many uses of antibiotics.

Antibiotics: does Medicare cover them?

Original Medicare, Part A and Part B, might cover antibiotics in certain situations.

  • Medicare Part A, hospital insurance, generally covers prescription drugs you take as part of your treatment as a hospital inpatient. So, if you had an infection in the hospital, Medicare Part A may cover medications (such as antibiotics) to treat it.
  • Medicare Part B, medical insurance, may cover prescription drugs administered to you in an outpatient setting – for example, if you receive medications through an infusion.

For most prescription drugs that you take at home, such as antibiotics, you may be able to find coverage under a Medicare Prescription Drug Plan. There are two main ways you can get this coverage under Medicare:

  • Through a stand-alone Medicare Part D Prescription Drug Plan. This kind of plan can work alongside your Part A and Part B coverage (you need to be enrolled in Part A and/or Part B to qualify).
  • Through a Medicare Advantage Prescription Drug plan. This kind of plan delivers your Medicare Part A and Part B benefits, along with your Part D (prescription drug) coverage, all in one plan. You need to be enrolled in Part A and Part B to qualify.

Both types of plans are available through private, Medicare-approved insurance companies. You must live within the plan’s service area, and continue paying your Part B premium, along with any premium the plan may charge.

Every Medicare Prescription Drug Plan maintains a formulary, or list of covered drugs. Check your plan’s formulary to see if your antibiotics are covered. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.

Do you have a Medicare Prescription Drug Plan? If you’re enrolled in one, I can help you go over the benefits and make sure it still may suit your needs. Or, I can help you find a different plan that may work for you.

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