The cost of multiple sclerosis (MS) drugs and services is covered by various sections of Original Medicare, Part D, and Part C, or Advantage plans.
MS is a chronic condition that affects the central nervous system. Nearly 1 million people in the United States and 2.8 million individuals worldwide have a diagnosis of MS.
Medicare is a government health insurance program primarily for older adults, but it also covers younger individuals who cannot work due to health reasons.
If a person has a diagnosis of MS, they will typically enroll in Medicare once they reach the qualifying age.
However, MS can lead to disability at any age, and if the condition affects a person’s ability to work, they may qualify for Medicare earlier than expected.
In this article, we explore the symptoms of MS and examine the coverage from:
- Original Medicare, or parts A and B
- Part C, known as Medicare Advantage
- Part D
- Medigap plans
We also compare the costs.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
The effects of MS on a person’s ability can change over time.
For example, the condition can cause vision changes that range from occasional blurred vision to complete vision loss. It can also cause symptoms such as tingling, weakness, or paralysis, which can impair mobility.
Therefore, as the disease progresses, the need for Medicare coverage can also change, involving different parts at different times.
Original Medicare
Original Medicare includes parts A and B.
Part A covers care in hospitals, hospices, and skilled nursing facilities, including the medications and therapies involved during these stays.
Part B covers many professional services and treatments that a person with MS might need, such as an injection or infusion in a medical clinic. Meanwhile, prescriptions have coverage from a different part of Medicare.
Part B also covers medically necessary durable medical equipment that a person with MS might need in their home, such as:
- cushions or mattresses that help relieve pressure
- aids for using the toilet
- canes
- walkers
- wheelchairs
- mobility scooters
A person can enroll in parts A and B separately, but many people choose to enroll in both to cover a broader range of healthcare needs.
Medicare Advantage
Also known as Part C, these plans are alternatives to Original Medicare that provide the same coverage.
Some offer additional benefits, such as:
- physical, occupational, or speech therapy
- eye care
- hearing care
- dental care
- wellness programs, such as gym memberships
One key difference is that private companies administer Part C plans, or Medicare Advantage, and a person must use doctors, pharmacies, and providers within the plan’s network.
A person is able to select which private company they use to enroll in Medicare Advantage.
Medicare Part D
Part D plans aim to cover prescribed medications, including many for MS. A person purchases one of these plans separately.
Each Part D plan has a list of covered medications, called a formulary, which the plan groups by price.
Medigap
Medigap plans help cover out-of-pocket costs, including deductibles, copayments, and coinsurance.
Each of the 10 Medigap plans has a payable premium. However, a person with MS may find that the additional coverage saves them money in the long term.
This online tool can help a person find a plan that best suits their needs.
Because a person with MS may require coverage from different parts of Medicare at different times, the costs can vary considerably.
The table below shows the basic costs of each Medicare part for 2025.
| Medicare part | Cost |
|---|---|
| Part A | The premium is generally free. However, depending on how long a person or their spouse worked and paid Medicare taxes, their premium may be $285 or $518 per month. The deductible is $1,676, and coinsurance depends on the number of days involved. |
| Part B | The basic premium is $185 with a deductible of $257. After the person meets the deductible, the cost of coinsurance is generally 20%. |
| Part C (Medicare Advantage) | The premium depends on a person’s plan. |
| Part D | Premiums vary between plans. A person may have to pay more, depending on their income. |
| Medigap | Premiums vary based on which policy a person buys, where they live, and other factors. |
A person can use this online tool to compare the costs of plans C and D.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
MS targets the nervous system and may harm the optic nerves, spinal cord, and brain.
The disease prevents nerves within the brain and spinal cord from communicating. Symptoms vary depending on the affected areas and change over time.
MS symptoms
- fatigue
- numbness or tingling in the arms and legs
- vision problems
- weakness
- depression
- memory problems
- issues with balance and coordination
Different types
There are five types of MS, including:
- clinically isolated syndrome, the first episode of MS
- relapsing-remitting MS
- secondary progressive MS
- primary progressive MS
- radiologically isolated syndrome, the rarest course of MS
Doctors believe the disease may occur due to issues with the immune system.
MS affects more females than males, and doctors typically diagnose it in people ages 20 to 40 years old.
The disease usually affects quality of life.
For most people, MS fatigue can affect what they can do from day to day. Sometimes, the condition leads to severe disability due to vision changes or difficulty walking. In other cases, people with the condition need to use a walker or wheelchair. MS is not fatal, but health complications, such as falling or pneumonia, may be life threatening.
Older research suggests that a person’s life span with MS is shortened by up to 7 years, but this is improving with more effective medication.
Though there is no cure for the disease, there are treatments, and receiving these early on can reduce the effects of MS in the long term.
Original Medicare, Medigap, Part D, and Part C — or Advantage — plans each cover various costs associated with multiple sclerosis (MS) care, including medications.
Because the symptoms of MS can change over time, a person may need coverage for visits to the doctor, in-hospital services, tests, therapies, and medications.