To confirm whether Part B will cover Prolia and what conditions must be met to have it covered, you will need to contact Medicare directly.
I believe Prolia has been covered under Medicare Part B for a number of years up to one injection every 6 months – typically required to be recommended by your physician. It can often be listed under Part D plans’ formularies as well, but as it is often administered by a doctor, it would typically be cited under Part B. Please note, Part D plans can change their coverage year to year – they are not guaranteed renewable and every plan is different. The drugs that a plan covers can change, the premiums, deductibles, copays, coinsurance, and other factors of a plan can change each year. Plans can even be terminated or replaced and therefore automatically disenroll the consumer, forcing them to select another plan. For the insured person, it’s vital they review their prescription drug coverage each year to determine what plan will best serve their needs for the coming year.
When Prolia is covered under Part B, a Medicare Supplement plan might cover the other 20% of the cost after Medicare pays it’s 80% share. Whether the Medigap insurer will cover the other 20% would need to be confirmed with a carrier – when it comes to drugs covered by Part B, there’s usually a couple extra conditions that have to be met for it to be covered as most drugs are covered by Part D.
I hope the information is helpful – please feel free to contact me for assistance with Medicare Supplement help. Thanks very much.