The short answer
Biologic drugs — complex medications made from living cells, used for conditions like rheumatoid arthritis and some cancers — are among the most expensive drugs there are. Biosimilars are highly similar, lower-cost versions of those biologics, approved as comparably safe and effective. For people on a costly biologic, a biosimilar can meaningfully cut costs, and Medicare covers them.
It's an option worth raising with your doctor if you take an expensive biologic.
How Medicare covers biosimilars
Depending on how a biologic or biosimilar is administered, it may be covered under Part B (for drugs given in a doctor's office, like many infusions) or Part D (for drugs you take yourself). Either way, choosing a biosimilar over the original biologic can lower your share of the cost. Our guide to how Medicare covers specialty and high-cost drugs explains how these pricey medications are handled.
Coverage of a specific biosimilar depends on your plan and how the drug is given, so it's worth checking your plan's details.
How to ask about switching
If you're on an expensive biologic, ask your doctor whether an approved biosimilar is available for your condition and appropriate for you. Because biosimilars are approved as comparably safe and effective, many patients can use them, though the decision is medical and belongs with your doctor.
For a drug that costs thousands, even a modest percentage saving matters. Our doctor and drug coverage tool helps you see how your plan covers your specific medications.
Frequently Asked Questions
What is a biosimilar?
A highly similar, lower-cost version of an expensive biologic drug, approved as comparably safe and effective. It can reduce costs for people on costly biologics.
Does Medicare cover biosimilars?
Yes. Depending on how the drug is administered, coverage may fall under Part B (office-administered) or Part D (self-administered). Choosing a biosimilar can lower your cost share.
How do I switch to a biosimilar?
Ask your doctor whether an approved biosimilar is available and appropriate for your condition. The decision is medical, but many patients can use them.
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