Medicare Coverage of a Nebulizer


What It Is

Nebulizer device to assist a patient at home with inhaled delivery of medication

What's Covered

Medicare Part B covers the rental or purchase of a nebulizer for use at home. The nebulizer must be prescribed by the patient's treating physician and used in conjunction with prescribed medication.

Medicare Part B doesn't cover disposable nebulizers.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for a nebulizer, contact the plan directly.

What Medicare Pays

Medicare Part B pays 80 percent of the Medicare-approved amount for the rental or purchase of a covered nebulizer.

**Warning:** If a nebulizer is rented or purchased from what's called a Medicare "participating supplier," the supplier can't charge more than the Medicare-approved amount for the device. However, a supplier who's enrolled in Medicare but isn't an officially "participating" supplier can charge more than the Medicare-approved amount. In that case, the patient must personally pay the difference between the Medicare-approved amount and the amount the supplier actually charges (on top of the 20 percent of the Medicare-approved amount that Medicare doesn't pay).

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

Was this medicareinformation helpful?

1 Comment So Far. Add Your Wisdom.

about 1 month ago

I have a problem with getting g supplies! One company y see to supply what I needed but has now said it does not deal with Medicare patients. However they are providing services to other Medicare covered patients! According to the information you provided on your site, if you h ave Medicare A and B these supplies should be covered as long as it has been deemed medically necessary by a physician! I need assistance !


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