Welcome to Medicare. School Daily, where we help you understand Medicare, save money,
avoid mistakes, and above all else, get the most out of your Medicare benefits. Now, today's
topic is, are any medications covered by Medicare A and B? And the answer to that is, yes, there
will be certain medications in certain circumstances that will be covered by Medicare A and B.
So let's break that down. The first question is this: What medications are covered under
Medicare Part A, well this would be a situation where you are in inpatient stay. This means
that you've been admitted to a hospital or to a skilled nursing facility, and as long
as that hospitalization or skilled nursing facility state is being covered by Medicare
Part A, that means that the meds are also covered by Part A while you're in that inpatient
situation. Secondly, what medications are going to be covered by Medicare Part B? This
would be meds that are necessary to be taken in an outpatient situation. Alight?
And so this would be infusion medications or maybe injectable medications, intravenous
medications, things like that, that you have to go to a facility to take those. Sometimes
ladies are diagnosed with osteoporosis, and they have to go to an outpatient facility
to take the shots. Typically, Prolia shots and Part B is going to pay for that because
it's administered in that particular clinic.
Now, one thing you must know, if it's ever going to be covered by Part B in an outpatient
situation, what has to happen is that outpatient facility must buy the medication, and they
must also supply the medication.
So they're providing it; they're also administering the medication. And that's when Part B is
going to pay for that. Also, there are times when insulin can be covered under Medicare
Part B. Now, keep in mind, I'm not saying all times that insulin is going to be paid
by Part B, only whenever Part B is covering; it's when you are using an external pump to
administer insulin. The external pump is paid through Part B and therefore the insulin that's
going to the pump is going to be paid through Part B as well. And then lastly, vaccinations.
Now, the vaccinations that are paid for through the Part B will be flu shots, pneumonia shots,
and hepatitis B. Now, there are a lot of other vaccinations that you may need, but those
are almost always going to be covered by drug plans. But Part B will pay flu, pneumonia,
and hepatitis B. So that's what's covered under Medicare Part B. And then the third
question is, what medications are covered by Part D?
Well, these are going to be medications that you self administer. These are going to be
typically your maintenance medications.
This could be for cholesterol. This could be for high blood pressure, maybe heart medications.
And the key to Part D coverage is this: that means that that prescription was filled at
your pharmacy.
So you went to the pharmacy of your choice and picked that medication up. And so meds
that you take at home are going to be paid through Part D. Now, I want to close with
a very important heads up here. If Medicare A and B is going to cover that particular
medication, as we looked at those just a couple of minutes ago, you want to be sure that you're
using the right insurance card. So always give in this scenario your Medicare card as
well as your supplemental plan. If you have a Medicare policy or they're called Medigap
policies, these would be typically F plans or maybe G plans or N plans. So you want to
be sure to give them both cards because Medicare is going to pay first and then the balance
of Medicare doesn't pay, then your supplemental plans should pick up those costs as well.
All right? And so be sure to use the right cards, because sometimes when a medication
is covered by A and B and you give them the wrong card, which would be the drug plan card,
then that is not going to be billed or paid correctly. But as long as you get both of
those cards when A and B covers it, that claim will go through and will be paid quite well by Medicare A or B.