Does Medicare Cover Prescription Drugs?
In general, you will have your doctor-ordered drug prescription filled by using your Medicare Advantage plan (which includes your drug coverage in most cases) or your Part D drug plan that you have with Original Medicare A&B. However, there are certain circumstances where your Medicare Part B will cover the cost of your prescription medications.
Your list of medications covered by your health plan is called a formulary. Even though Medicare will cover these items or services, there may be additional deductibles, co-pays, or co-insurance in certain circumstances.
Below is the list of topics for medications covered by your Part B of Medicare. You simply go to www.medicare.gov and search for drug coverage using the search box at the top of the homepage. By entering the phrase “Is your test, item, or service covered” an entire inventory of procedures and services will appear. Since the list is alphabetized, it will make finding the specific information easy to locate.
Examples of drugs covered by Part B:
Drugs used with an item of durable medical equipment
Some antigens Injectable osteoporosis drugs
Erythropoiesis-stimulating agents Blood clotting factors
Injectable and infused drugs
Oral End-Stage Renal Disease (ESRD) drugs.
Parenteral and enteral nutrition (intravenous and tube feeding) Intravenous Immune Globulin (IVIG) provided in the home Shots (vaccinations)
Transplant drugs (also called immunosuppressive drugs
Oral cancer drugs
Oral anti-nausea drugs
Self-administered drugs in hospital outpatient settings
Who’s eligible? All people with Part B are covered under limited conditions. Your costs in Original
Medicare…
For covered Part B prescription drugs, you get in a doctor’s office or pharmacy
For covered Part B prescription drugs, you get in a hospital outpatient setting
For drugs that Part B doesn’t cover in a hospital outpatient setting
For example: if you are undergoing cancer treatment, the medications or pills could be covered by
Medicare Part B even though you have a drug plan. Check with your Pharmacist when ordering these specific
medications. You may find that one of the two coverage options will save you co-pays or even be issued at no cost. Medications issued while in the hospital or Out-Patient are covered by your Part Aand Part B of Medicare
Source: www.medicare.gov