Psyllium, or psyllium husk, is a plant-based fiber supplement available over the counter (OTC) in most pharmacies and big-box stores. It is available in different forms, such as powders and gummies, in both generic and brand-name options.
In general, Medicare does not cover OTC products, such as psyllium, but there are some exceptions. Whether Medicare may cover psyllium depends on a person’s specific Medicare plan.
The following forms of Medicare will not cover psyllium and other OTC fiber supplements:
- Original Medicare (parts A and B)
- Part D prescription drug plans
- Medicare supplement insurance (Medigap)
Original Medicare includes extensive coverage for inpatient and outpatient medical care and certain medications for use in those settings. However, OTC drugs and supplements do not fall under the scope of Original Medicare.
Since Original Medicare does not cover psyllium, Medigap will not cover it either. Medigap plans are private, supplemental insurance plans that help with the out-of-pocket expenses of parts A and B.
Finally, Part D drug plans will not cover psyllium, as it is not a prescription drug.
For Medicare to cover psyllium, a person will need to have a Medicare Advantage plan with OTC benefits. They then may be able to use their benefits to buy psyllium from a participating retailer.
Most Medicare Advantage plans include some level of OTC benefits, which work slightly differently depending on the insurer and plan.
Generally, people receive an OTC card that works like a debit card, and they can use it at specific retailers to buy eligible products. The product catalog will likely include psyllium or a comparable fiber supplement.
For example, the Walgreens OTC benefits cover a variety of psyllium products from Metamucil.
If someone has questions about their OTC coverage, they can check their plan’s Evidence of Coverage (EOC) documentation or contact a plan representative.