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Dealing with asthma is not fun, to put it mildly. The shortness of breath, coughing, and wheezing can, at best, be a challenge to your everyday life. At worst, it can cause a life-threatening attack.
Unfortunately, there is no cure for asthma yet. The good news, however, is that its symptoms can be treated and controlled.
One of the main ways to treat asthma is by using asthma inhalers. So a common question many people have is, “Does Medicare cover Asthma Inhalers?” In this article, we answer this question in clear, plain English. You will also find the average costs of asthma inhalers and other helpful info.
Does Medicare Cover Asthma Inhalers?
The short answer is yes; Medicare will cover the cost of an asthma inhaler. But not 100% of the time. As is often the case with Medicare, you must meet certain conditions in order for Medicare to pay for your asthma inhaler. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for asthma inhalers costs.
Specifically, coverage for asthma inhalers under Medicare Part B. Asthma inhalers are what’s known as Durable Medical Equipment (DME) in Medicare. And Medicare Part B provides coverage for DME.
However, for Medicare Part B to cover asthma inhalers, your healthcare provider must first prescribe one for you and provide a form stating why it is medically necessary.
Medicare Part B will also cover nebulizers along with the cost of albuterol (if you use it with a nebulizer). Other than asthma inhalers and medications, Medicare also provides coverage for asthma treatment, including outpatient asthma rehabilitation.
Medicare Advantage plans (Medicare Part C) also provide coverage for asthma inhalers. They cover everything Original Medicare covers as well as some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.
Medicare Part D also provides coverage for asthma inhalers. But similar to Part B’s coverage, you will need a prescription from your healthcare provider before Medicare Part D covers asthma inhalers.
Additionally, Medicare Advantage plans with Part D may cover Symbicort which Original Medicare does not cover. Medicare Part D also covers albuterol as long as it is used with an asthma inhaler.
Costs for these treatments under Medicare Part D vary depending on your plan type. To find out which Medicare Part D plans cover rescue inhalers and what their costs are, you can compare different Part D plans in your area.
How Much Does Asthma Inhalers Cost?
An asthma inhaler’s exact cost will depend on various factors. A main one being if the inhaler is branded or generic.
Generic asthma inhalers usually cost somewhere from $50 to $90. However, similarly branded asthma inhalers such as Advair, Symbicort, Dulera, and Breo may cost $300 to $400.
Generic Asthma Inhalers vs Brand Names
There are more and more generic inhaler options out there. And by using one, you can potentially save a lot of money compared to the brand names.
Generics use the same active ingredients as their brand name counterparts. And research shows them to be as effective as the brand name options.
However, not all brand names have a generic option available, especially for combination inhalers. If you want to know if there is a good generic option out there for you, please consult with your doctor and/or pharmacist.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover Botox for migraines?