Does Medicare Cover Antibiotics?
Last Updated : 11/11/20193 min read
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
- Giardia (an infection caused by parasites in untreated water)
- Sexually transmitted diseases (STDs), according to the National Institutes of Health
- Staph infections (staphylococcus aureus)
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.
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