I am often asked about Medicare Part B drugs and how they are different from Medicare Part D drugs. The answer is fairly straight forward. A Medicare Part B drug is any drug that is administered to the patient by injection or IV at the doctors office or some other Medical facility.
When this is the case, the drug falls under the Medicare Part B benefit. It is not a part D drug and will not fall under your Rx benefits. In other words, it is treated like a medical benefit instead of a drug benefit.
There is one exception to this. If the patient/member picks up the drug at the pharmacy and then has it administered to them by the doctor or at the facility, it may still fall under the Medicare part D drug benefit. The difference is that the patien actually purchased it at the pharmacy vs. it being supplied by the doctor of facility.
Part B drugs are covered at 80% by most Medicare Advantage plans, leaving the member to pay 20% of the cost which can be increadibly expensive. Aetna Medicare Advantage plans are an exception to this rule as they only charge a $50 copay for Part B drugs vs. 20% of the cost.
The other good way to cover part B drugs is to have a Supplement in place. A plan F or C will cover the Part B drug at 100%.
If you have specific questions or need any information, please email Edward Crowe at [email protected] or ca