Does Medicare cover iron infusions?

Part B covers most drugs that a licensed provider gives you by shot or IV. That usually means in a doctor's office or a hospital outpatient clinic. IV iron fits that rule.

The FDA approves IV iron drugs for people who:

• Have iron deficiency anemia (low blood iron that causes low red blood cells), and iron pills did not help or caused side effects
• Have long-term kidney disease
• Have low iron along with heart failure (one drug is approved for this)

Medicare pays when your doctor's records show you need it, usually with blood tests that show low iron. Iron pills are a different story. Part B does not usually cover drugs you take yourself at home.

In short: if your doctor gives you IV iron for a medical need, Part B pays most of it.

Medicare sets an approved amount for each iron drug, per unit. Doses come from each drug's FDA label for an adult who weighs at least about 110 pounds. Here is the approved amount for one full course of the drug, from October to December 2026, and your 20% share:

• Ferric carboxymaltose, 1,500 mg in two doses a week apart: about $1,682. You pay about $336.
• Ferric derisomaltose, 1,000 mg in one dose: about $2,188. You pay about $438.
• Ferumoxytol, 1,020 mg in two doses 3 to 8 days apart: about $338. You pay about $68.
• Iron sucrose, 1,000 mg in five doses over 14 days (the label dose for kidney disease not on dialysis): about $224. You pay about $45.

Two older drugs are priced per unit. Iron dextran is about $19.01 per 50 mg. Sodium ferric gluconate is about $1.96 per 12.5 mg. Your dose depends on your weight and lab results.

These amounts are for the drug only. The visit and the infusion itself are billed too, and you owe a share of those. At a hospital clinic, you also pay a copayment for the hospital's services.

• If you have a Medigap plan: every plan pays some or all of your 20% share.
• If you have Medicare Advantage: your plan sets its own copay or coinsurance and may need to approve the drug first. Check your plan's Evidence of Coverage.
• If you have Medicaid too: Medicaid may pay your share. Ask your state Medicaid office.

Ask your doctor which iron drug they plan to use. As the list above shows, your share can differ by hundreds of dollars from one drug to another.

1. Get blood tests. Your doctor checks your iron and red blood cell levels.
2. Tell your doctor what you tried. If iron pills did not work or made you sick, make sure that is in your record.
3. Get the infusion where Medicare is accepted. For Part B drugs, providers must accept assignment. That means they cannot charge you more than your share for the drug.
4. Check your bill. Your Medicare Summary Notice lists the drug, the infusion, and what you owe.
5. If Medicare says no, appeal. Your Medicare Summary Notice explains how. Ask your doctor for a letter with your lab results.

In short: with lab tests that show low iron and a doctor's order, Part B covers the infusion. Ask which drug you will get, since your share depends on it.