Does Medicare Cover Ensure? 

Eating healthy and staying active are two of the most important things seniors can do for their health, but sometimes, medical conditions and injuries can make it difficult to enjoy a nutritious diet. Whether due to mobility concerns that don’t allow for meal preparation or healthcare concerns that affect digestion, suffering from malnutrition can create serious medical problems that can be life-threatening.

How is malnutrition treated in seniors?

Treatment for malnutrition requires the introduction of proper nutrition, but how this is handled depends on the cause of the malnutrition. If someone simply has a poor diet, taking proactive steps to eat better can often reverse the effects of malnutrition. In cases where a digestive disorder is causing the malabsorption of nutrients, prescription medications or surgery may be necessary to correct the problem.

In severe cases of malnutrition, treatment may necessitate the intravenous introduction of nutrients in an inpatient setting. Seniors who require this type of nutrition are often dehydrated as well, so fluids are introduced at the same time via IV. If someone is unable to eat during an inpatient stay, a gastric-nasal feeding tube may be used. This method of feeding involves placing a flexible tube through the nasal cavity and down the throat where nutrients can be directly inserted into the stomach. In cases where this is not an option, a feeding tube may be surgically implanted into the stomach through the abdomen.

Supplemental nutrition is another option for seniors who are unable to get the nutrients they need from a normal diet. Products like Ensure, made by Abbott Labs, offer nutritional support in a single-serve beverage that can be purchased from retail pharmacies and many grocery and department stores. Additionally, health food stores may also stock Ensure and other nutritional supplement beverages. Each Ensure beverage contains enough nutrients to replace a meal, but before taking Ensure for nutritional supplementation, you’re encouraged to speak with your doctor.

Does Medicare cover Ensure?

Although Medicare Part D provides prescription drug coverage for medications purchased from retail pharmacies, this type of coverage is not available for Ensure. Medicare benefits under Original Medicare do not provide coverage for supplements or over-the-counter medical products. Because Ensure is a non-prescription over-the-counter product, it is not eligible for Medicare coverage.

If, however, you are provided Ensure while staying in a Medicare-participating hospital or skilled nursing facility, you may be able to receive coverage for Ensure through Medicare Part A. The inpatient benefits of Medicare Part A offer coverage for up to 60 days of hospital care or 20 days of inpatient care in a skilled nursing facility each benefit period.

If care is required beyond these limits, additional inpatient services may be an option at a per-day rate. For hospital care, Medicare benefits offer up to 90 total days before Medicare recipients must use lifetime reserve days. For skilled nursing facility care, up to 100 days are available.

Medicare Advantage plans may cover Ensure

Despite Medicare coverage not being available for Ensure through Original Medicare, a Medicare Advantage plan may offer benefits that can be applied toward the purchase of Ensure. A Medicare Advantage plan must provide the core benefits of Original Medicare, but providers of Medicare Advantage plans have the option to include additional benefits.

Some Medicare Advantage plans offer discounts, coupons and rebate programs on the purchase of certain healthcare products and medical services, but these vary from provider to provider. If your Medicare Advantage plan provider allows it, you may be able to receive a direct discount on the purchase of Ensure at a pharmacy or grocery store, but this benefit would not be related to Original Medicare coverage directly. Instead, it would be a separate benefit tied to the Medicare Advantage plan provider. If you’re enrolled in a Medicare Advantage plan, check your benefits to find out more.