Many patients prefer to be covered under part D of Medicare health insurance plan as it helps them in getting their medicines at lower prices. However, most of them are not aware of how to get medicines under the plan they have selected. It should be noted that the medicines that are covered under plan D of Medicare can vary for different plans. But, all the plans contain the medicines required for each major therapeutic category. Hence, patients can be assured of getting the medicines for any illness under their selected plan. Patients can get medicines from all categories, including anticonvulsant, antipsychotic, antiretroviral, antidepressant, anticancer and immunosuppressant medicines, as per part D of Medicare. For getting these medicines, they need to select a plan that accommodates their prescription drugs in the best possible manner. They should also consider the premium they have to pay for these plans, because if they select a plan having a wider range of drugs, naturally they have to pay a higher premium.
The plans also vary depending upon their coverage of generic or branded medicines. Some plans provide coverage of generic medicines and some cover a wide range of branded drugs. If patients want to get branded drugs, they need to pay a higher premium.
Patients can get their drugs under part D of Medicare, depending upon the list of medicines they have selected. However, if their current medical condition does not respond well to these medicines, they have the option of getting other medicines that may be of a higher value. However, for doing this, approval from the physician is needed. If the treating doctor has already tried medicines of a lower cost, or generic medicines, without any satisfactory improvement in patient’s condition and if he feels that the patient needs medicines that are of a higher value, then the Medicare provider can permit the patient to use medicines of a higher cost. Patients can get the medicines prescribed by the doctor only in the quantity specified by him.
Part D of Medicare also contains vaccines. Patients can get commercially available vaccines under this part.
Some patients also have questions regarding how to get medicines under part A and B of Medicare. It is important to mention that part A does not cover medicines prescribed on an outpatient basis. However, drugs that are prescribed to the patient during an inpatient stay are covered by this part. Part B of Medicare also covers a few prescription medicines, to some extent. But, patients have to first pay the deductible amount of the medicine before Medicare pays its share. The medicines covered under part B are those that are administered as a part of physician’s service. Self administered drugs are not covered under this part. Most injections and infusion medicines are covered in Part B.
Part B also covers major vaccinations. Patients can get flu shots and pneumococcal vaccinations under this plan. Apart from this, they can also get hepatitis B vaccines and other vaccines that are needed for treatment of injuries, like the tetanus vaccine, under part B.
Injectable medicines that are used by women for treatment of osteoporosis are also covered under part B. Some other essential medicines that are covered under Medicare part B are antigens, Erythropoiesis-stimulating Agents, Blood Clotting Factors, Immunosuppressive Drugs and Oral Anti-Cancer Drugs.
I am a 66 year old man. I am covered under part A of Medicare. I am not getting all the medicines that I need for treating the illness I am suffering from. I am planning to shift to part D of Medicare. Please advise me whether doing so will help me in reducing my healthcare expenses.
This article has given a good explanation about how patients can get their medicines under Medicare plans. The article is very simple and can help many of us to understand the medicine coverage rules of part D. Thanks for the information.