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What Medications are covered under Part B?

Certain types of medications fall under Medicare Part B instead of Part D. If you have original Medicare with a traditional supplement, these medications will generally be fully covered.  If you have opted for a Medicare Advantage plan, you will pay the plan’s coinsurance as outlined in their benefit summary.  With many Medicare Advantage plans, this might be a 20% cost-share for you, but your Part B spending will count toward your plan’s out-of-pocket maximum.

The primary categories of prescriptions that sometimes fall under Part B are:

  • Drugs provided in a physician’s office, such as chemotherapy medications
  • Medications administered via durable medical equipment, such as nebulizers or internal or external pumps
  • Immunosuppressive meds – commonly given after an organ transplant
  • Some oral cancer or related anti-nausea medications that you administer to yourself
  • Some medications that treat End-Stage Renal Failure – an example would be Erythropoietin
  • Drugs delivered in a hospital outpatient care situation
  • Vaccines ordered by a physician, such as pneumonia or hepatitis vaccines
  • Blood clotting factors
  • Diabetes supplies – lancets, test strips, glucose monitors

Learn More: Are Vaccines Covered by Medicare Part D?

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