Is enteral formula covered under Medicare Part B?

• A. Formula is not covered under Part B.
• B. Formula is covered under Medicare Part B, but the patient will be financially responsible for 20%.
• C. Formula is fully covered with no patient responsibility.
• D. Formula coverage depends on ESRD.

Answer: (B)

Medicare Part B covers enteral nutrition formulas when they are medically necessary and prescribed for home tube feeding. In this arrangement, Part B pays 80% of the approved amount after you meet the Part B deductible, and the patient is responsible for the remaining 20% coinsurance. ESRD does not affect this coverage—it's not the deciding factor. So the formula is covered under Part B with patient cost-sharing, not fully covered with no out-of-pocket cost.