Does Medicare Pay for Remicade Infusions? Costs in 2026-2027
Reviewed October 16, 2026. Yes, Medicare pays for Remicade (infliximab) infusions. Because Remicade is given by IV infusion in a doctor’s office, infusion center or hospital outpatient department, it’s covered under Medicare Part B, not Part D. After you meet the Part B deductible, you generally pay 20% of the Medicare-approved amount for the drug and the infusion, unless a Medigap policy or other coverage picks up that share.
Quick answer: With Original Medicare in 2026 you pay the $283 Part B deductible once a year, then about 20% of each Remicade infusion. Medigap Plan G or Plan F can cover that 20%. With a Medicare Advantage plan you pay the plan’s Part B drug coinsurance up to its out-of-pocket limit, and the plan may require prior authorization. CMS hasn’t published 2027 Part B amounts yet.
Why Remicade is covered under Part B
Medicare.gov says Part B covers “most injectable and infused drugs when a licensed medical provider gives them,” including drugs given in a doctor’s office or hospital outpatient setting. (Medicare.gov: Part B drugs) Remicade is an infused biologic used for conditions such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis, and it’s always given by a health care provider, so it falls under Part B. Your Part D plan doesn’t pay for it.
Coverage still requires that the infusion is medically necessary for your diagnosis and given by a provider who accepts Medicare. For more on the rules, see does Medicare Part B cover prescription drugs.
What you pay for Remicade infusions
| Your coverage | What you typically pay |
|---|---|
| Original Medicare only | $283 Part B deductible (2026), then 20% of the Medicare-approved amount for the drug and the infusion service, with no yearly cap |
| Original Medicare + Medigap Plan G | The Part B deductible; the plan pays the 20% coinsurance |
| Original Medicare + Medigap Plan N | The Part B deductible; the plan pays the coinsurance (small copays apply only to some office and ER visits) |
| Medicare Advantage | The plan’s Part B drug coinsurance (often up to 20%), counted toward the plan’s yearly out-of-pocket limit; prior authorization may apply |
| Medicaid or QMB with Medicare | Usually little or nothing; Medicaid pays Medicare cost sharing for QMB members |
Because Remicade is a costly biologic given every several weeks, the 20% can add up quickly on Original Medicare alone. That’s the main reason people who need regular infusions often choose a Medigap plan, or a Medicare Advantage plan with a reasonable out-of-pocket maximum. Compare Medigap Plan G vs Plan N and check the Part B deductible.
Lower coinsurance for some Part B drugs
Since April 1, 2023, the Inflation Reduction Act has lowered coinsurance for certain Part B drugs whose prices rise faster than inflation. For those drugs, coinsurance is 20% of a lower, inflation-adjusted amount, and the list can change each quarter. (CMS: Medicare inflation rebate program) Ask your infusion center whether a reduced coinsurance applies to the infliximab product you receive.
Remicade biosimilars and Medicare
The FDA has approved several infliximab biosimilars, which are covered the same way under Part B when given by infusion: Inflectra (infliximab-dyyb), Renflexis (infliximab-abda) and Avsola (infliximab-axxq). A fourth, Ixifi, was discontinued. (FDA biosimilar list) Your doctor or your Medicare Advantage plan may prefer one product over another. Zymfentra, an infliximab you inject under the skin yourself, was approved in 2023 for maintenance treatment of ulcerative colitis and Crohn’s disease; drugs you give yourself are generally handled through Part D, so check your drug plan’s formulary.
Remicade with Medicare Advantage in 2027
Medicare Advantage plans must cover Remicade because Original Medicare does, but they set their own cost sharing and can require prior authorization or step therapy for Part B drugs. If you get regular infusions, check these items in each plan’s 2027 Summary of Benefits and Evidence of Coverage during Open Enrollment (October 15 to December 7, 2026):
- The coinsurance for “Medicare Part B drugs” and for chemotherapy or infusion services
- The in-network out-of-pocket maximum for 2027
- Whether your rheumatologist or gastroenterologist and your infusion center are in network
- Prior authorization or step-therapy rules for infliximab
Our annual plan review checklist walks through these steps.
How to keep Remicade costs down
- Ask about the site of care. Infusions in a physician office or independent infusion center can cost less than in a hospital outpatient department.
- Ask about biosimilars and whether reduced coinsurance applies.
- Check Medicare Savings Programs. If your income and assets are limited, a QMB program can pay your Part B premium and cost sharing.
- Manufacturer copay cards generally can’t be used with Medicare, but independent charitable foundations may help with Part B costs.
Frequently asked questions
Is Remicade covered by Part B or Part D?
Part B, because it’s infused by a health care provider.
How much does a Remicade infusion cost with Medicare?
With Original Medicare alone, about 20% of the Medicare-approved amount after the $283 deductible (2026). A Medigap plan or Medicare Advantage out-of-pocket cap can limit that.
Does Medigap cover Remicade?
Medigap plans pay some or all of the Part B coinsurance for covered infusions. Plan K pays 50%, Plan L pays 75%, and plans such as G and N pay the full coinsurance.
Does Medicare cover Inflectra or Renflexis?
Yes. Infliximab biosimilars given by infusion are covered under Part B in the same way as Remicade.
This article is general information, not medical advice. Medicare365 is an independent website and is not affiliated with or endorsed by Medicare, any government agency, Janssen or any insurance carrier.