Does Medicare Cover Nebulizer Use?

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What is a nebulizer?

A nebulizer is a machine that delivers liquid prescription medications in a fine mist that you can inhale. Your doctor might prescribe medication to use with a nebulizer to help open your airways if you have certain health problems such as asthma or chronic obstructive pulmonary disease (COPD)

There are three types of nebulizers:

  • Jet. This uses compressed gas to make an aerosol (tiny particles of medication in the air).
  • Ultrasonic. This makes an aerosol through high-frequency vibrations. The particles are larger than those made by a jet nebulizer.
  • Mesh. Liquid passes through a very fine mesh to form the aerosol. This kind of nebulizer puts out the smallest particles. It’s also the most expensive.

Talk to your doctor about whether a mouthpiece or a mask is right for you or your child. Face masks, which fit over the nose and mouth, are often better for children under 5 because they breathe through their noses more than older children and adults do.

What are nebulizers used for?

Nebulizer therapy is often called a breathing treatment. You can use nebulizers with a variety of medications, both for controlling asthma symptoms and for relief right away. These include:

  • Corticosteroids to fight inflammation (such as budesonide, flunisolide, fluticasone, and triamcinolone)
  • Bronchodilators to open your airways (such as albuterol, formoterol, levalbuterol, and salmeterol)
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Does Medicare cover nebulizers?

Medicare may help pay for nebulizers that are deemed medically necessary by your doctor, such as if you have COPD.

Nebulizer devices are Durable Medical Equipment (DME), which is covered by Medicare Part B.

Nebulizer cost

Beneficiaries pay 20 percent of equipment costs, plus the Part B deductible. Medicare pays the other 80 percent. The amount may vary among plans. Medigap plans may also help with nebulizers and medication costs.

You should always check with your providers to ensure they accept the assignment before making any decisions. Some doctors are enrolled in Medicare but choose not to participate. If a doctor doesn’t take the insurance, the cost of your equipment or service might be affected.

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