Does Medicare cover Symbicort?

Question

Chris Smith · Accepted Answer

Symbicort is typically prescribed as a metered-dose inhaler. This is not covered by Original Medicare. It is most often covered by a Medicare Part D prescription drug plan.

However, if the appropriate criteria are met, Medicare Part B may cover the active ingredients budesonide and formoterol respectively when they are prescribed as a nebulized solution for use with an at-home nebulizer. It is important that the nebulizer is medically necessary and prescribed as durable medical equipment (DME).

Nathan Curry · Answer

Original Medicare does not cover any prescription that you pick up at the pharmacy. Only medication administered by a physician is covered under Part B.

If you have Original Medicare with a Medicare Supplement, you would need a separate Part D prescription drug plan and would want to make sure Symbicort is included on that plan's formulary.

The same applies if you have a Medicare Advantage plan that includes prescription drug coverage. Always check the plan's formulary, which is simply its list of covered medications, to see whether Symbicort is covered and what your cost would be.

Renee Silver · Answer

Original Medicare generally does not cover Symbicort when it is used as a self-administered prescription inhaler. Most beneficiaries receive coverage for Symbicort through a Medicare Part D plan or a Medicare Advantage plan with prescription drug coverage (MAPD).

Many Medicare prescription drug plans cover Symbicort or its generic equivalent, but the cost depends on your specific plan's formulary.

Clarence &quot;Mark&quot; Christiansen · Answer

It is plan dependent, and many plans cover the generic, budesonide/formoterol. The best way to check if any of your drugs are covered by Medicare is by going to the Medicare.gov website. From there, you can click "find a plan," then key in your ZIP code, the name of the drugs you are interested in and then select several pharmacies because a preferred pharmacy will typically get you a better price. Do you have an insurance agent who can help you? Please like me can assist and there is no added cost for a licensed agent to help you find a plan that fits.

Answered by Clarence "Mark" Christiansen on October 5, 2026

Agent Licensed in WI, AZ, CA & 16 other states

Answered by Clarence "Mark" Christiansen Medicare Insurance Agent

Jon Cavanaugh · Answer

If you only have Original Medicare, Symbicort would not be covered. Coverage would typically come through a Part D prescription drug plan or a Medicare Advantage plan that includes drug coverage.

Since every plan has its own drug list, it's important to check whether it covers brand-name Symbicort or the generic version and what your cost would be.

I recommend reaching out to an independent Medicare broker in your area. They can check plans from multiple carriers to see how Symbicort is covered.

Rose Cahill · Answer

The answer is: It depends!

Most Medicare Advantage plans and Part D drug plans cover a generic version of Symbicort, like budesonide-formoterol (like Breyna). Many plans do not cover the brand name Symbicort. It's important to check each plan's specific formulary before deciding.

Trever Dahms · Answer

Yes, Symbicort is covered under Medicare Part D. However, coverage depends on each insurance company’s formulary (their list of covered drugs). Some plans cover brand-name Symbicort, while others only cover the generic version, budesonide-formoterol fumarate.

Answered by Trever Dahms on October 12, 2026

Broker Licensed in FL, NC, SC & WI

Answered by Trever Dahms Medicare Insurance Agent

Mark Boone · Answer

Yes, Symbicort and its generic equivalent (budesonide/formoterol), are covered, primarily through Medicare Part D prescription drug plans or Medicare Advantage plans that include drug coverage. Original Medicare itself does not cover self-administered prescription inhalers filled at a retail pharmacy

Answered by Mark Boone on October 23, 2026

Agent Licensed in MN, FL, MI & NC, OH, SC & VA

Answered by Mark Boone Medicare Insurance Agent

Brady Kidwell · Answer

Yes,   Medicare can cover Symbicort through a Part D drug plan or a Medicare Advantage plan that includes drug coverage. Whether the brand is covered and what you pay depend on your plan’s covered-drug list, called its formulary. Original Medicare Parts A and B generally don’t cover this pharmacy-dispensed inhaler.

Your plan may require prior authorization or prefer another medication

Daniel Bayless · Answer

Medicare often covers generic versions of Symbicort and will rarely, with doctor's orders, cover brand Symbicort. Check with your plan formulary and exception rules. Your agent can help with that!

Hector Leguillow · Answer

You have to be on a Part D drug plan or have a Medicare Advantage Plan with Drug coverage. You may need prior authorization and, depending on your plan, only be approved the generic version.

Mindy Berry · Answer

Although Symbicort may be covered by Medicare, each carrier/plan may place this medication on a different tier, determining their cost. When your agent runs your medications for cost and coverage, they should be able to give you the cost for both monthly and yearly for your medications.

Answered by Mindy Berry on July 30, 2026

Agent Licensed in OH, FL, GA & 12 other states

Answered by Mindy Berry Medicare Insurance Agent

Chris Carothers · Answer

Yes, I see in my "calculator" in 2027 Medicare does cover Symbicort under Medicare Part D, which is your Prescription Drug Plan, with Medicare. Please verify with your plan, that your medications are still listed as covered on your plan formulary for drug coverage every year.

Answered by Chris Carothers on October 26, 2026

Agent Licensed in NV, AZ, FL, NM, TX & UT

Answered by Chris Carothers Medicare Insurance Agent

Robert Reed · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/does-medicare-cover-symbicort#robert-reed

Does Medicare cover Symbicort?

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