Introduction

Osteoporosis—a thinning and weakening of the bones—affects millions of older adults and can lead to serious injuries from falls or everyday activities. Early detection and ongoing management are crucial for seniors wishing to maintain their mobility and independence. Medicare beneficiaries should know which osteoporosis screenings, medications, and treatments are paid for so they can proactively guard their bone health.

Bone Density Testing Under Medicare

Bone mineral density (BMD) testing, also called a DEXA scan, is the most common way to screen for osteoporosis or analyze risk. Medicare Part B covers the cost of this test for eligible beneficiaries every two years (or more often if medically necessary) if you meet one or more of the following risk factors:

Estrogen deficiency (commonly in postmenopausal women not on estrogen therapy)
A prior vertebral fracture or radiological finding
Taking long-term steroid medicines known to reduce bone density
Diagnosed with primary hyperparathyroidism
Being monitored for current osteoporosis drug therapy

The BMD scan is fully covered (no coinsurance or deductible applies), provided the acceptable frequency and clinical conditions are met.

Medicare Coverage for Osteoporosis Medications

Maintaining strong bones sometimes requires more than diet and lifestyle changes. Several prescriptions are used to prevent additional bone loss or reduce fracture risk. Medicare Part D prescription plans and some Medicare Advantage policies cover drugs such as:

Bisphosphonates (alendronate, risedronate, ibandronate)
Hormone related therapies (teriparatide, raloxifene)
Injectable denosumab for high-risk patients (doctor administered, billed under Part B for some cases if patient cannot self-administer medication)

Coverage depends on the drug formulary your plan offers. Some medications are covered only for those who meet specific medical criteria such as evidence of high fracture risk or previous adverse events with older drugs. Ask your provider and pharmacist to identify approved formulary choices and request exceptions if medically needed drugs are not listed.

Other Covered Osteoporosis Treatments and Services

Physical therapy: Under Part B, you may qualify if bone loss is tied to injury or inability to perform daily activities. Exercises focus on strength, balance, fall reduction, and overall safety.
Yearly wellness exams: Review ongoing need for therapy, medication tolerance, risk blending with other chronic conditions, and promote coordination of care among your health professionals each year.
Preventive education: Nutrition, exercise counseling and fall risk management, all often included during annual checkups or Medicare wellness visits;

Tips for Maximizing Bone Health with Medicare

Accept your initial and repeated DEXA scans early, especially if you have known osteoporosis risk factors.
Understand your plan’s medication copays and drug tiles; compare cost options each annual renewal to avoid price jumps for needed medications.
Report sudden pain, posture changes, or new mobility issues to your provider for consideration of new bone imaging or treatment adaptation.
If supplements—like vitamin D or calcium—are required, review whether your plan covers specific diagnoses or after-hospital discharge supplies;

Get Guidance for Healthy Bones and Smart Coverage Choices

Preventing brittle bone complications means using every benefit for assessment, medication, and daily lifestyle improvement that Medicare offers. If you have questions about qualifying for advanced testing, tailoring osteoporosis drug plans, or need support with coverage coordination among all care teams, contact Vista Mutual Insurance Services. We are ready to assist in making your plan support every step toward strong, healthy bones and confident living at every age.

Medicare and Treating Osteoporosis What is Covered