Key takeaways:
Medicare Part B and Part D cover many available psoriasis medications, including topicals, oral medications, biologics, and phototherapy.
Still, out-of-pocket costs for treatment vary widely. There are ways to reduce the cost of treatment, including switching from a reference biologic medication to a biosimilar.
Other options include manufacturer assistance and Medicare Extra Help.
Many Medicare enrollees need treatment for psoriasis. Of course, some treatments can be costly, so it’s important to know if treatment is covered by original Medicare, Medicare Advantage, and Medicare Part D.
Here’s a quick refresher on the different plans:
Medicare Part B: Part of original Medicare, Part B covers visits with healthcare professionals, lab tests, X-rays, scans, some preventive services, and certain durable medical equipment.
Medicare Part C: Known as Medicare Advantage (MA), this is an alternative private plan that replaces Medicare Part A (hospital) and Part B (medical). MA plans often include benefits that aren’t typically covered by original Medicare. But each plan has different rules, costs, and coverage limitations.
Medicare Part D: This covers prescription drugs and treatments. Part D is a standalone plan with original Medicare. It is typically included with a Medicare Advantage plan.
Even with coverage, people with original Medicare spent more than $6,600 annually on out-of-pocket costs in 2019. Here we’ll review Medicare coverage of common psoriasis treatments and additional ways to save.
Which psoriasis treatments does Medicare cover?
Medicare reimburses many costs related to psoriasis treatment, including in-office appointments and certain medications. These include oral medications, topicals, and biologics.
Oral medications
Most Part D plans cover oral medications for psoriasis, including:
Topical medications
Almost all Medicare Part D plans cover topical medications, such as:
Betamethasone dipropionate (Diprolene)
Clobetasol (Clobex, Tovet)
Fluocinonide (Vanos)
Hydrocortisone (Locoid)
Biologics
Part B or Part D may cover biologic and biosimilar treatments for psoriasis. Some Medicare Advantage plans may also cover certain services.
Part B often covers outpatient treatments like injectable and infused medications when administered by a licensed medical provider. Examples include:
Part D often covers self-administered medications like injection pens. Examples include:
Cimzia prefilled syringes
Cosentyx (secukinumab)
Enbrel (etanercept)
Humira (adalimumab)
Skyrizi (risankizumab)
Stelara (ustekinumab)
But coverage depends on the specific medication and plan. For example, Humira and Tremfya are widely covered by most Medicare Part D plans, but Taltz usually is not covered.
Phototherapy
Original Medicare and Medicare Advantage cover phototherapy. They require:
A psoriasis diagnosis
A prescription for phototherapy
Determination of medical necessity
Medicare Part A covers care provided in a hospital. Part B covers outpatient and at-home therapy.
Ways to save
Many psoriasis treatments — especially those that are newer — carry high prices. One way you can help patients with cost is to consider prescribing a biosimilar medication if it’s appropriate and available. Biosimilars can cost more than 50% less than their reference counterparts. Biosimilars saved U.S. consumers more than $9 billion in 2022.
Currently, these psoriasis reference biologics have biosimilars available:
Here are some other ways your patients may be able to lower or offset the expense of psoriasis care.
Contact the manufacturer. Most manufacturers of brand-name prescription drugs and reference biologics offer patient assistance programs, which often do allow Medicare recipients to apply, as long as they meet certain financial requirements. People with Medicare are often not eligible for copay card programs, however.
Seek an exception. There are two kinds of exceptions. A tiering exception can reduce copay costs for a high-tier medication. Unless the medication is in a specialty tier, patients can ask for cost sharing for a lower tier. The other exception is a formulary exception, which allows a request for a medication that’s not on the plan’s formulary.
Consider Medicare Extra Help. This is a federal program that helps lower out-of-pocket expenses for prescription medications under Medicare Part D. People with limited income and resources may qualify.
Choose GoodRx. Patients can’t use GoodRx with Medicare Part D. But it can make sense for them to use a GoodRx coupon when Medicare doesn’t cover a medication. It’s also a good call when the GoodRx price is less than the Medicare prescription plan copay. GoodRx can help your patients compare medication prices among pharmacies in their area.
The bottom line
Original Medicare and Medicare Advantage plans cover many treatments for psoriasis. Part B covers treatments administered by a healthcare professional, whereas Part D covers prescription medications taken at home. Other options for savings include manufacturer assistance, GoodRx coupons, and Medicare Extra Help.
Why trust our experts?
References
Centers for Medicare & Medicaid Services. (n.d.). Treatment of psoriasis.
Centers for Medicare & Medicaid Services. (2023). Exceptions.
Medicare.gov. (n.d.). Help with drug costs.
Medicare.gov. (n.d.). Prescription drugs (outpatient).
Medicare.org. (2025). Does Medicare cover ultraviolet light therapy?
Medicare Interactive. (n.d.). Requesting a tiering exception.
Noel-Miller, C. (2023). Beneficiaries in traditional Medicare: Out-of-pocket spending for health care. AARP Public Policy Institute.
