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Does Medicare Cover Anemia?

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When you have anemia, your blood doesn’t carry enough oxygen to the rest of your body because you don’t have enough red blood cells. According to the National Heart, Lung, and Blood Institute, the most common type of anemia is caused by an iron deficiency.

What’s the treatment for anemia?

Your doctor will likely decide how to treat anemia in your case, based upon the type, cause, and severity of your condition.  The Mayo Clinic lists a range of treatments for various types of anemia, which are summarized below.

  • Treatment for anemia caused by an iron deficiency. Your doctor may recommend that you eat more food that’s high in iron, and perhaps take an iron supplement.
  • Treatment for anemia caused by vitamin deficiency. If you have folic acid and B-12 deficiencies, your doctor might advise you to take dietary supplements; however, if your body has trouble absorbing these nutrients, your doctor may order vitamin B-12 shots.
  • Treatment for anemia caused by a chronic health condition. In some cases, your health-care provider may recommend treating the underlying chronic disease, if you have one. This could include surgery, antibiotics, chemotherapy, other medications, or a combination of therapies. If your anemia is severe, however, treatment may involve blood transfusion or injections of synthetic erythropoietin, which stimulates red blood cell production.
  • Treatment for sickle cell anemia. Your doctor may order oxygen, pain medications, and oral and intravenous fluids to reduce pain and prevent complications. Blood transfusions, folic acid supplements and antibiotics may be part of the treatment.
  • Treatment for anemia caused by blood or bone marrow diseases. Various types of blood or bone marrow diseases can cause anemia. If you have such a disease, your doctor may treat it with medication, chemotherapy, bone marrow transplantation, or by surgery to remove your spleen.

Does Medicare cover treatment for anemia?

Typically Medicare Part A (hospital insurance) provides coverage for treatment for anemia if you’re admitted to the hospital as an inpatient. Medicare Part B (medical insurance) may provide coverage for doctor’s visits, including care related to the diagnosis of and treatment for anemia.

Medicare Part B might also cover outpatient prescription medications in certain situations. For example, Medicare may help pay for erythropoietin shots to treat anemia resulting from kidney disease. Similarly, Medicare Part B may cover monthly vitamin B-12 injections (and more frequent injections during the initial or acute phase of anemia) administered by your doctor or a licensed nurse as treatment for anemia. Medicare Part B might also cover iron injections as treatment for anemia.

Generally, Medicare doesn’t cover vitamins and dietary supplements. However, a Medicare Prescription Drug Plan may cover prescription drugs not covered by Medicare Part B. If you are enrolled in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan, you can call your plan and ask if it covers the medications and supplements you may be taking as treatment for anemia.

In most cases you are responsible for paying the Medicare deductible and any applicable copayment or coinsurance amount. If you have a Medicare Supplement plan or other insurance, it may help pay some of these out-of-pocket expenses.

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