Does Medicare Cover B-12 Shots? 

Vitamin B12, also known as cobalamin, is an essential nutrient that plays an important role in keeping the body functioning properly. If you don’t get enough vitamin B12 from your food, you might need to take supplements to maintain an optimal level of this water-soluble vitamin. 

Vitamin B12 helps the body produce red blood cells and prevent anemia, maintains a healthy nervous system, supports bone strength and density, helps stave off dementia and low cognitive function, and B12 boosts energy production throughout the body. 

Some people, as they get older, tend to be deficient in vitamin B12. The most common reasons leading to this condition in the elderly are:

• Age-related inability to absorb vitamin B12 sufficiently 
• Digestive system issues such as celiac or Crohn’s disease
• A limited diet that’s lacking in essential nutrients 
• Taking a prescription medication like metformin that depletes or blocks the absorption of vitamin B12 
• Having had surgery that removed a portion of the stomach or small intestine 
• Following a strict vegan or vegetarian diet.

How do you know if you have may need B12 shots?

You might have a vitamin B12 deficiency if you have any of the following symptoms:

• Very pale or yellow skin
• Severe fatigue or weakness
• Mouth ulcers
• Feeling breathless or dizzy
• Changes in mood like depression, irritability, or psychosis
• Pins and needles sensations in extremities
• Diminished appetite

See your health care provider if you have any of these common symptoms of vitamin B12 deficiency. If your doctor suggests that you need B12 shots, your Medicare insurance might help you cover some of the expenses. 

Will your Medicare benefits cover B12 shots?

If you’re enrolled in Original Medicare Part B(medical insurance), you may qualify for coverage for vitamin B12 injections under the following conditions:

• Your health care provider certifies that B12 injections are medically necessary to treat or prevent a health condition. 
• This health care provider accepts Medicare assignment.
• A licensed health care provider administers your B12 shots at an outpatient facility or physician’s office that also accepts Medicare assignment. 

In general, Medicare Part B covers some outpatient prescription drugs that you can’t take yourself at home, but it doesn’t cover vitamin B12 shots in all instances, so discuss your options with your physician. 

Medicare Part B pays for 80 percent of the final approved cost for your injections and the health care provider’s fees for administering them if you’re eligible for the benefit. You pay 20 percent of this cost after covering your annual Part B deductible. 

If you need vitamin B12 shots for a medically necessary reason while you’re an inpatient in a hospital or a skilled nursing facility that accepts Medicare assignment, Original Medicare Part A (hospital insurance) covers these expenses as part of your hospital care. You are responsible for covering the deductible for the current benefit period before Medicare Part A pays its share of your expenses. 

If you’re enrolled in a Medicare Advantage (MA) plan, your private insurance provider is obligated to cover, at minimum, all benefits included in Original Medicare Parts A and B. 

Most MA plans also offer extra benefits and additional coverage to enrollees, so you may have greater access to vitamin B12 shots. However, depending on the type of Medicare Advantage plan you have, you might need to use network providers that are approved by your plan provider to be eligible for your benefits. 

If you aren’t sure whether you have network restrictions, or you don’t know what your out-of-pocket expenses are for B12 shots, contact your provider for details before making health care appointments. 

How much do vitamin B12 injections cost without Medicare insurance? 

How much you pay for B12 shots depends on the type of injection, where you have them administered, where you purchase them, and what the dosage is. The national average cost for one B12 injection that your physician administers in their office is between $35 and $80. You might need to pay additional fees for the administration.