Does Medicare Cover Ensure?

Medicare Benefits Solutions
Jan 22, 2021

Eating right is one of the keys to staying healthy, and along with exercise, a balanced diet can help you to manage your weight, prevent medical issues like heart disease, and possibly extend your life expectancy.

For many Americans, however, eating properly can be difficult due to digestive problems, cognitive impairment, trouble chewing and more. For these individuals, protein shakes and meal replacement drinks like Ensure can often be the difference between getting the right nutrition and not receiving nourishment at all.

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Medicare Coverage for Ensure

Although Ensure can be utilized by adults of all ages, it is often used as an optimal nutrition source by seniors who either need additional nutrition and can’t eat traditionally or who have certain medical needs that only a product like Ensure can meet. These older Americans typically fall into the age range of people who qualify for Medicare, and many wonder whether or not Medicare covers Ensure.

While Original Medicare benefits offer assistance in nutrition through doctor visits and lab work, Medicare does not cover the purchase of Ensure. Medicare Part D does cover prescription medications that can be purchased at retail pharmacies, but Ensure is not a medication despite being available from major retail pharmacy stores. As a result, if you purchase Ensure, you will be responsible for the full cost.

It may be possible, however, for Ensure to receive coverage by Medicare if it is provided by a hospital during admission. This provision would fall under Medicare Part A, the inpatient benefit. This coverage would only be provided if the hospital provides Ensure and only during your admission stay.

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What is Ensure?

Ensure is a brand of beverages manufactured by Abbott Laboratories. It was released in 1973, and today, Ensure is available from various major retailers across the United States.

Ensure does not require a prescription and contains no medications. If you plan to utilize Ensure as a meal replacement option or as supplemental nutrition, it is recommended that you discuss your diet and dietary concerns with your doctor prior to making any major changes to your diet.

Medicare Advantage and Ensure coverage

Although Original Medicare coverage does not offer benefits for Ensure, you may be able to save money on Ensure or similar meal replacement products with a Medicare Advantage plan.

These are plans that provide the same minimum coverage that is offered by Original Medicare, but they also often include additional benefits.

In some cases, a Medicare Advantage plan may provide discounts on certain nutritional products like Ensure.

TIP: Use our plan finder tool and find out if your existing Medicare plan covers nutritional consultation services.

Nutritional Counseling and Dietitian Coverage

Although Ensure can help some people to maintain a healthy lifestyle, there are times when more intensive treatment options are needed. These cases may call for the services of a nutritionist or dietitian who can assist a Medicare recipient with managing diet around an ongoing disease.

Medicare does offer coverage for nutritionist services in limited cases involving kidney disease or diabetes. A nutritionist or dietitian will evaluate your current health, provide treatment options and offer monitoring and follow-up services as needed. Medicare benefits provide this coverage with no co-pay or deductible required although the services are treated as being covered under Medicare Part B.

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