Does Medicare Cover Atrovent?
Last Updated : 09/10/20184 min read
According to the National Institutes of Health’s Medline Plus website, Atrovent is a brand-name formulation of the generic prescription drug ipratropium. It’s used to treat symptoms of chronic obstructive pulmonary disease (COPD), which affects the lungs and air passages. Atrovent is a bronchodilator; it works by relaxing and opening the airways to make it easier to breathe.
If your doctor prescribes nebulizer treatment with Atrovent or ipratropium, it may be covered under Medicare Part B. If it is prescribed as an aerosol inhaler, Original Medicare (Part A and Part B) usually does not cover Atrovent.
When does Medicare Part B cover Atrovent?
Atrovent (ipratropium) is generally available in two preparations, according to Medline Plus:
- As a liquid solution used with a nebulizer machine that turns it into a mist you inhale through a mask
- As a self-contained canister-type inhaler that releases pre-measured puffs, or doses.
Your doctor will decide which type of Atrovent treatment is best for your lung condition and symptoms.
Medicare Part B may cover ipratropium as part of your Durable Medical Equipment (DME) benefits. If your doctor prescribes Atrovent for use with a nebulizer machine, both the nebulizer and the ipratropium solution used with it may be considered DME. Here’s how Part B coverage of Atrovent works:
- Both your doctor and the provider who supplies your nebulizer and medication must accept Medicare assignment.
- Your doctor must prescribe ipratropium (or Atrovent) and the nebulizer as medically necessary.
- If you live in a part of the country affected by the Medicare Competitive Bidding Program, an initiative to help control DME costs, you must get your Atrovent and nebulizer machine from a supplier who is contracted under the program.
If you meet the conditions listed above, you’ll typically pay 20% of the Medicare-approved amount plus any applicable Part B deductible, for the nebulizer machine and the ipratropium solution.
For more details about the Competitive Bidding Program, and Medicare coverage of nebulizers and associated medications as DME, see medicare.gov.
Does Medicare cover Atrovent inhalers?
A Medicare plan that includes prescription drug coverage might cover an ipratropium inhaler. Each of these plans has its own formulary, or list of covered medications. Of course, plans may change their formularies occasionally, you will receive notice from your plan when necessary.
These plan options are described below. Your out-of-pocket costs for these plans may vary, as will plan availability.
How can I get Medicare Part D prescription drug coverage for Atrovent?
In general, there are two ways to get prescription drug coverage under Medicare. They’re available through private insurance companies that contract with Medicare, instead of coming directly from the federal government program.
- A stand-alone Medicare Part D Prescription Drug Plan can work alongside your Original Medicare (Part A and Part B) coverage.
- A Medicare Advantage Prescription Drug plan can provide your Medicare benefits; see details below.
The Medicare Advantage (Medicare Part C) program offers another way to get your Medicare Part A and Part B benefits – through a private, Medicare-approved insurance company instead of directly through the government. Medicare Advantage plans must include at least the same coverage as Original Medicare (except for hospice care, which is still covered under Part A), but they can choose to offer additional benefits such as wellness programs. Most Medicare Advantage plans include prescription drug coverage to help you manage your health conditions. Under Medicare Advantage, you’re still in the Medicare program, so you need to continue paying your monthly Part B premium along with any premium your Medicare Advantage plan may require.
Whether you decide on a stand-alone Medicare Part D Prescription Drug Plan, or a Medicare Advantage Prescription Drug plan, you might want to check the plan’s formulary for Atrovent or ipratropium and any other prescription medications you may take to make sure they’re covered. To start comparing plans and see if they cover your prescriptions, just click the Find Plans button on this page.
Do you still have questions about your options for Medicare coverage of ipratropium or Atrovent? I’d like to help. You can request information via email or schedule a phone call at your convenience by clicking one of the links under this article. To see a list of plans in your area that you may qualify for, click the Compare Plans or the Find Plans button. You can also find out more about me by clicking the “View profile” link.