Will Your Insurance Cover Your Vitamins?
Surveys have estimated that 77% of Americans take dietary supplements, and we spend approximately $35 billion yearly on these over-the-counter (OTC) products. The overwhelming majority (98%) of dietary supplements are minerals and vitamins.
Some of these products are taken to treat specific symptoms, while others are taken as part of preventive health care practices because they are believed to prevent illness, boost immunity, aid weight loss, or supplement nutrition from dietary intake.
Whatever the reason, vitamins and dietary supplements are a significant part of the nation’s health care costs overall.
But are vitamins prescription drugs? And do health insurance plans cover vitamins? Please continue reading to find out.
Can my doctor prescribe vitamins?
There are two types of vitamin supplements. Over-the-counter (OTC) vitamins, minerals, and herbs are ones that you can purchase off-the-shelf in pharmacies, grocery stores, and online without a doctor’s prescription.
The other kind of supplements are prescription supplements, which you can only get with a prescription from your doctor. For example, if your annual blood tests show that you are deficient in a certain vitamin or mineral, your doctor may recommend an OTC product. However, if the deficiency is severe, your doctor may prescribe something such as vitamin D supplements.
Health care providers might prescribe a supplement if you have special dietary needs or if you’re taking a medication that can potentially deplete a vitamin or mineral. The prescription supplement is given to ensure that you don’t develop a deficiency of a vital nutrient, giving dietary supplements parity with prescription drugs.
What’s the difference between OTC and prescription vitamins?
OTC supplements are readily available off-the-shelf without a prescription. They are not regulated by the U.S. Food and Drug Administration (FDA), but this does not mean that OTC supplements are harmful. It just means that you can’t be sure they actually contain what they claim to contain and will do what they claim to do.
On the other hand, prescription supplements are specialty supplements that are carefully regulated by the FDA. They are reviewed for safety and efficacy to ensure they can treat a specific health condition or improve health. For example, some prescription supplements are prescribed with treatments like chemotherapy. Others are given to patients with specific metabolic disorders or medical conditions like kidney disease.
Moreover, you can report adverse effects of prescription vitamin supplements to the FDA’s MedWatch reporting system. This helps to track a drug’s safety and recall it if deemed unsafe.
Both OTC and prescription vitamins can add to your medical expenses. Before spending money on OTC supplements, it might be worth asking your doctor if they can prescribe a vitamin instead. The prescription version of a vitamin might be covered as a medical expense by your insurance plan.
Are vitamins covered by insurance?
It depends on the type of insurance plan. In some cases, it might be cheaper to take a prescription supplement that’s covered by your health insurance plan rather than an OTC product.
If your insurance company does not cover prescription drugs such as vitamins, you can explore other options like asking your doctor to switch you to something that is covered. You can also use a free BuzzRx drug discount card to get big discounts on many prescription supplements.
Does Medicare cover vitamins?
Generally speaking, Medicare Part D doesn’t cover vitamin supplements. However, every Medicare Prescription Drug Plan has its own formulary. Some Medicare plans, such as Medicare Part D offered by Medicare-approved private insurance companies, may cover certain supplements. Medicare Prescription Drug Plans with an “enhanced alternative coverage” might offer coverage for supplements, bringing down your health care costs.
Medicare Part B often provides coverage for vitamins and supplements that your doctor considers necessary for the treatment of a medical condition. Some of the vitamins that Medicare may cover include:
- Prenatal vitamins
- Vitamin D analogs like calcitriol for low calcium levels or bone disease
- Niacin (vitamin B3) for dyslipidemia
- Sodium, potassium, calcium, and magnesium supplements to boost levels in people with electrolyte deficiencies
- Fluoride supplements
- Prescription supplements for loss of muscle mass in HIV/AIDS patients
Can I get reimbursed for vitamins?
Generally speaking, your insurance company will not reimburse you for OTC supplements. However, prescription supplements may be covered and reimbursable. Keep in mind that most insurance companies require pre-approval for prescription vitamins. This is usually a straightforward process when your doctor prescribes a vitamin to treat a qualifying diagnosis, condition, or symptom.
It’s a good idea to do some quick research before your appointment. You might find discount coupons for prescription vitamins. This way, you can discuss the specific products with your doctor and use the coupons to save on your prescriptions.
What are some doctor-recommended vitamins?
Vitamin D supplements are one of the most common doctor-recommended vitamins. Other dietary supplements commonly prescribed by doctors include calcium for bone health, folic acid for folate deficiency anemia, omega-3 fatty acids (fish oil), and niacin for dyslipidemia (high cholesterol levels).
If I’m already taking OTC supplements, should I ask my doctor to give me prescription versions?
In some cases, you might save money by asking for prescription versions of OTC supplements that your doctor prescribes. For example, if you’re pregnant, a prescription prenatal vitamin with folic acid may be covered by your insurance plan, and you can avoid paying out of pocket for an OTC version.
Is it worth spending money on vitamins?
Most healthy individuals can get the vitamins and minerals they need from a healthy, balanced diet. However, some people need dietary supplements. For example:
- Pregnant women need folic acid supplements for the healthy development of the baby.
- Older adults don’t absorb vitamins as well and may need vitamin B12, vitamin D, iron, and calcium supplements.
- People with vitamin deficiencies or certain autoimmune disorders, or chronic inflammatory conditions like inflammatory bowel disease may need dietary supplements.
- The use of some herbal products like anti-inflammatory turmeric for arthritis and blood-sugar-lowering cinnamon for prediabetes/diabetes is supported by small studies. However, these supplements lack strong scientific evidence.
If you choose to take a dietary supplement as part of preventive health care practices, always follow the advice of a trusted medical professional. Don’t rely on vitamins as a quick fix or home remedy for specific medical conditions. Your doctor is the best person to tell you whether you should take a vitamin or supplement and the expected outcomes from its use. You should know that indiscriminate use of dietary supplements can cause more harm than good.
And whether your insurance company will provide coverage for vitamins? Check with your doctor to see if you qualify for a prescription version, which is more likely to have health insurance coverage.