I use several prescription apps and digital therapeutics for my chronic conditions. Does Medicare provide any coverage for digital health tools in cases like mine?

Question

Leslie Kaz · Accepted Answer

Medicare’s coverage for prescription apps and digital therapeutics (DTx) is limited but evolving, particularly for chronic conditions. Original Medicare (Parts A and B) typically does not cover DTx, as these tools often fall outside defined benefit categories. However, recent developments show some progress; so the answer would depend on what your currently using.

Answered by Leslie Kaz on April 28, 2025

Broker Licensed in CA, AL, AZ & 7 other states

Answered by Leslie Kaz Medicare Insurance Agent

Tasha Riggs · Answer

Yes. As long as your providers contract with Medicare. It is up to the provider to be contracted by Medicare to take their payments

Marcie Barnes · Answer

Your question requires more details to give the best answer.  I suggest you call licensed expert to further assist you.

Tony Hardwick · Answer

Medicare has expanded coverage for digital health tools. To be eligible for coverage digital tools must be FDA cleared, used as part of a broader treatment plan, and the provider must incur costs of the tool.

Answered by Tony Hardwick on April 28, 2025

Agent Licensed in GA, AZ, CA & 15 other states

Answered by Tony Hardwick Medicare Insurance Agent

Robert Baez · Answer

The Medicare statute does not directly address coverage of digital health technologies, nor does the statute specifically limit or prohibit coverage of digital health technologies within the program’s benefit categories. Please check with your insurance carrier for more details.

Answered by Robert Baez on April 11, 2025

Agent Licensed in IL

Answered by Robert Baez Medicare Insurance Agent

Bob Nunn · Answer

I would advise go to Medicare.gov/coverage  or call 1-800-633-4227 if it’s not on previous website list .

Chuck Winslow · Answer

As of January 2025, Medicare has begun covering certain digital therapeutics (DTx) specifically for mental health conditions, such as depression, insomnia, and substance use disorders. These are FDA-cleared, prescription-based software tools designed to deliver clinical interventions, and they are now reimbursable under the Medicare Physician Fee Schedule. ​

However, for chronic physical conditions like diabetes or kidney disease, Medicare's coverage of digital health tools remains limited. While Medicare does provide reimbursement for remote patient monitoring (RPM) services—such as tracking blood glucose or blood pressure—this coverage is typically indirect, billed through your healthcare provider as part of their care management services. ​

It's important to note that Medicare Advantage plans may offer additional digital health benefits, including wellness apps or chronic care management tools, but these offerings vary by plan. If you rely on specific digital therapeutics for managing your chronic conditions, it's advisable to consult with your healthcare provider or Medicare plan administrator to determine if these tools are covered under your current plan.

Lenora Sikkenga · Answer

As of January 2025, Medicare does have coverage for digital therapeutics and apps but for mental health only. As far as I have researched mental health conditions are the only ones covered. I would have to do more research.

Answered by Lenora Sikkenga on April 10, 2025

Broker Licensed in NV

Answered by Lenora Sikkenga Medicare Insurance Agent

I use several prescription apps and digital therapeutics for my chronic conditions. Does Medicare provide any coverage for digital health tools in cases like mine?

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I use several prescription apps and digital therapeutics for my chronic conditions. Does Medicare provide any coverage for digital health tools in cases like mine?

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