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

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

Answered by Leslie Kaz Medicare Insurance Agent

Mark Bilgere · Answer

Beginning in January of 2025, Medicare did approve some Digital Therapeutics when order by a provider. The approved therapeutics are:
SleepioRx for Insomnia
Somryst for Chronic insomnia
DaylightRx for Generalized anxiety disorder
Rejoyn for Major depressive disorder	
reSET for Substance use disorder
reSET‑O	for Opioid use disorder

Daniel Brechin · Answer

The only answer that I will give you is that we need to look them up to ensure you are in the correct program.  Prescription Drug Programs are given a list of drugs they must cover.  Any others may, but until  I get the drug, I cannot tell you yes or no.    
Danny Brechin
Contact me.

John Becker · Answer

As of January 1, 2025, Medicare covers select FDA-cleared prescription digital therapeutics (PDTs) for treating chronic conditions like depression, anxiety, and insomnia. These, often called Digital Mental Health Tools (DMHTs), require a doctor's prescription and must be designed for specific, evidence-based treatment, not general wellness. 

Key details on Medicare's coverage for digital tools:
What is Covered: Coverage includes the app itself, necessary accessories, and the associated provider fees for monitoring. Specific examples include tools for chronic pain or mental health.

Payment Model: The new policy allows providers to buy and then bill Medicare for these tools.

Action Needed: You must have your healthcare provider submit a claim, as they must be the ones to "procure" or prescribe the product.

Alternative Coverage: While not direct device coverage, you may be able to have monitoring services covered under Medicare's Chronic Care Management services. 

To confirm coverage for your specific apps, you should check with your doctor to see if they are considered "FDA-approved digital therapeutics" and are eligible for billing codes introduced in the 2025 Medicare Physician Fee Schedule.

Nikki Rowland · Answer

Yes, Medicare has recently started covering a select group of FDA-approved digital health tools—known as prescription digital therapeutics (PDTs)—especially for chronic and mental health conditions.  If you're using digital therapeutics for chronic conditions, it's worth checking with your provider and Medicare plan to see if your specific apps are eligible.

1. These apps must be prescribed by a provider who contracts with Medicare.

2. Billing is typically handled by the provider—not a pharmacy—and may involve new medical codes created by CMS.

3. Some Medicare Advantage plans may offer broader coverage, including setup, monitoring, and even the device (like a tablet) needed to run the app.

It all depends on what digital tools you are referring to in order to answer this with complete certainty.  I would be happy to help you find out.

Justin Doherty · Answer

For now, there are only 7 apps that are eligible under Medicare. However, coverage generally requires a prescription and an unusual billing process that involves the providers instead of pharmacies. Sadly, these hurdles will likely cause more roadblocks to getting help paying for digital therapeutics.

That being said, the 7 apps currently eligible are:
1) SleepioRx for insomnia 2)Daylight for anxiety 3) Rejoyn for depression 4) reSET for substance use disorder 5) reSET-O for opioid use disorder 6) Somryst for chronic insomnia 7) MamaLift Plus for maternal mental health

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

Alicia Hoilman · Answer

Medicare just recently approved coverage for certain digital therapeutics for mental health treatment beginning January 1, 2025. Although it may still be limited, there are now digital mental health treatment devices that a physical can prescribe and Medicare will cover. This includes apps and software for treating anxiety, depression and insomnia.

Answered by Alicia Hoilman on June 11, 2025

Broker Licensed in VA, DE, FL & MD

Answered by Alicia Hoilman Medicare Insurance Agent

Jeffrey Horn · Answer

Yes—but in a limited and very specific way, and it’s gradually expanding as digital health becomes more integrated into care. Coverage typically applies only when these tools are prescribed by a doctor and meet Medicare’s criteria for medical necessity.

Answered by Jeffrey Horn on March 25, 2026

Agent Licensed in IL, AZ, CO & 17 other states

Answered by Jeffrey Horn Medicare Insurance Agent

Timothy Baggett · Answer

Medicare does provide some coverage for digital health tools, but it depends on how the technology is used and whether your doctor is involved. 

Under Part B, Medicare pays for remote patient monitoring when you have a chronic condition and your provider orders an FDA approved connected device that sends health data (like blood pressure, oxygen levels, weight, or similar readings) to their office for ongoing management.

That being said most stand alone wellness apps, subscription programs, and general health trackers are not covered

Raymond Arce · Answer

Hi there!

Medicare’s coverage for prescription apps and digital therapeutics really depends on the specific plan you have. Basic Medicare usually doesn’t cover most digital health tools, but some Medicare Advantage plans do offer extra benefits for things like certain wellness apps or digital therapeutics.

It’s a good idea to review different Medicare plan options—some may be a better fit if you rely on these types of digital tools. Let us know if you need help comparing plans or have more questions!

Rob Rockey · Answer

Hello, Medicare may cover certain doctor-prescribed digital therapeutics or remote monitoring tools, but most general health apps aren’t covered. Share the app names and I can check for you.

Diana Garner · Answer

Yes, as of January 1, 2025. Medicare will now pay for certain digital therapeutics used for mental health treatment, which are FDA-approved digital health apps.

Ron Cronwell · Answer

Digital Therapeutics may be covered under original Medicare, but on a case by case basis. Medicare Advantage Plans also on a case by case basis.

According to "HealthCare Brew" A history of challenges
This latest development is a long time coming.

The FDA cleared the first DMHT for market, Pear Therapeutics’s reSET, in 2017. But in April 2023, Pear declared bankruptcy and reSET, plus its opioid use disorder program reSET-O, were sold to digital treatment provider PursueCare. In a LinkedIn post, Pear’s former CEO partly blamed its collapse on payer denials.

In September 2023, Akili Interactive—a digital medicine company that created an FDA-authorized prescription video game to treat ADHD—abandoned the prescription model after hitting roadblocks from payers, and offered its video game-based treatment over the counter.

These new codes may get more payers on board, Andy Molnar, SVP of industry affairs at trade group American Telemedicine Association (ATA) and head of digital health at advocacy arm ATA Action, told Healthcare Brew.

“We’re in such a better place now in 2025 than we have ever been before,” he said, explaining that now it’s possible to “actually start to show real-world evidence and cost data” to convince Congress to further expand coverage.

The Medicare test
So far, seven apps qualify for CMS’s HCPCS codes, according to the DTA:

Big Health’s SleepioRx for insomnia and Daylight for anxiety
Otsuka Precision Health and Click Therapeutics’s Rejoyn for depression
PursueCare’s reSET for substance use disorder and reSET-O for opioid use disorder
Nox Health’s Somryst for chronic insomnia
Curio’s MamaLift Plus for maternal mental health
But even with Medicare coverage, challenges remain.

Check with your professional and the insurance provider.

Walt Smith · Answer

I am aware that Medicare covers digital health tools when it comes to mental health conditions I am not aware of and the other general applications.

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, AZ, FL, OH & TX

Answered by Robert Baez Medicare Insurance Agent

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

Hugo Luis Mion · Answer

It all depends on what Medicare Advantage plan the medicine qualifies for. All the plans and Medicare Advantage companies have different coverage for medicine.

Juan Osborn · Answer

Yes, Medicare does offer FDA-approved digital therapeutics (DTx) for mental health treatment. This requires a doctor's prescription. There is also coverage for remote patient monitoring that gathers physiologic data for ae and chronic conditions.

Answered by Juan Osborn on September 20, 2025

Agent Licensed in CA, CO, GA & 9 other states

Answered by Juan Osborn Medicare Insurance Agent

Marcie Barnes · Answer

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

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.

Robert Nunn · Answer

I would advise going to Medicare's website or calling them. if it’s not on the previous website list.

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

Broker Licensed in GA, AL, AR & 32 other states

Answered by Tony Hardwick Medicare Insurance Agent

Raid Alemam · Answer

Yes Medicare starting 2025 offers coverage for certain digital therapeutics  health tools.  Some Medicare advantage plans may offer coverage for general medication management or wellness apps.

Rick Balistreri · Answer

Medicare's coverage for digital health tools is evolving. Some digital therapeutics, particularly those related to mental health, are now reimbursable, although coverage for other chronic conditions may still be limited. Coverage for digital therapeutics targeting various chronic conditions is still under consideration in 2025.

Answered by Rick Balistreri on May 19, 2025

Agent Licensed in MO, AZ, FL & 7 other states

Answered by Rick Balistreri Medicare Insurance Agent

Theresa Furth · Answer

Yes, Medicare now covers a selection of FDA-approved prescription digital therapeutics (PDTs) for chronic and mental health conditions. Check plan benefits to see if setup, monitoring and the device are covered. A prescription will be required.

Answered by Theresa Furth on October 30, 2025

Agent Licensed in VA, FL, ME & 5 other states

Answered by Theresa Furth Medicare Insurance Agent

Kelly Anderson · Answer

Yes, Medicare currently provides coverage for select FDA-approved digital and therapeutics. It is important to work with your providers and agent to make sure your devices will be covered.

Vanessa McKinney · Answer

Yes, Medicare offers digital health, mainly through telehealth services. Also some therapeutic for mental health conditions.

Randy Sanchez · Answer

Hello, it would depend on whether the digital tools fall under the category of a Medicare covered service/device. If it is a Medicare covered service/device then it is covered. I recommend reaching out to your current plan/agent. If you are on original Medicare then to each out to Medicare directly.

Kind regards, 
Contact me