Medicare Coverage for Osteoporosis (2026)

What Medicare covers for osteoporosis

• Bone density (DXA) scan: Every 24 months covered at $0 if at risk; more often if medically necessary.
• Prolia (denosumab) injections: Every 6 months, covered under Part B at the doctor's office or under Part D if self-administered.
• Reclast (zoledronic acid) infusion: Annual infusion under Part B.
• Oral bisphosphonates (alendronate, risedronate): Tier 1 generics on Part D — typically $0.
• Forteo (teriparatide) and Evenity (romosozumab): High-cost anabolic agents under Part B (Evenity) or Part D (Forteo). The 2026 cap helps.
• Endocrinologist or rheumatologist visits: Under Part B for management.

Best plan structure for osteoporosis

For most osteoporosis patients, Original Medicare + Medigap covers Prolia and Reclast under Part B with no out-of-pocket after Medigap. Self-administered orals on Part D are cheap.

For Forteo or Evenity (anabolic agents that cost $20k–$30k/yr), the $2,000 Part D cap (Forteo) and Medigap (Evenity under Part B) keep costs predictable.