What Are Some Other Drugs That May Be Covered by Part B or Part D?There are several other drugs that may be covered by Part B or Part D, depending on what they are used for and how they are administered.

 

 

 

DrugCoverage under Part BCoverage under Part D
Antigens

Administered by your doctor or self-administeredNot covered.
Erythropoietin (Epoetin Alpha or Epogen)If you have End-Stage Renal Disease (ESRD), are receiving dialysis, and need this drug to treat anemia. It may be administered by your doctor, ESRD facility, or you may administer it if you are selected for a home therapy program.

If you have conditions other than ESRD and the drug is administered by your physician.
If you have conditions other than ESRD and you purchase it at the pharmacy.
Hemophilia Clotting FactorsYou must have hemophilia. Only covered if it is self-administered.Not covered.
Infusion drugsDrugs administered by an implantable infusion pump

Drugs administered by an external infusion pump that you use at home, and your local DME contractor covers them under Part B.
Drugs administered by an external fusion pump outside of the home (i.e. in a skilled nursing facility or hospital) if your stay is not covered by Part A or you do not have Part A

Drugs administered by an external fusion pump that you use in the home, but your DME contractor does not cover them under Part B for use in the home.

Infusion drugs administered at home without an infusion pump at home. One example of this is an IV push.
Inhalation drugs (provided by infusion/durable medical equipment supplier)Drugs used with a nebulizer in the home.Drugs used with a nebulizer in a skilled nursing facility or as an inpatient in the hospital and your stay is not covered by Part A or you do not have Part A.

Drugs administered without a nebulizer.
For example: metered-dose inhalers, dry powder inhalers, nasal spray inhalers. In some cases, the inhaler itself may be covered by your Part D plan.
Injectable Osteoporosis Drugs for women who meet certain conditions.You receive Medicare home health benefits and you have a bone fracture related to post-menopausal osteoporosis. You also must not be able to administer the drug yourself and the Medicare home health agency provides you with the drug.You do not receive Medicare home health benefits or you meet the requirements for Part B coverage, but you purchase the prescription directly from the pharmacy.
Intravenous ImmunoglobulinIf you use it to treat immune deficiency disease and it is used in the homeIf you use it to treat conditions other than immune deficiency disease and it is used in the home.
Oral anti-cancer drugsIt is an oral anti-cancer drug that was once available only in an injectable form that was covered by Medicare. You or your doctor can administer the drug. It must be used to treat cancer.You use the drug to treat a condition other than cancer.
Oral anti-nausea drugsMust be related to cancer, used as a full replacement for intravenous treatment, and administered within 48 hours of cancer treatment. It can be administered by yourself or by a doctor.The drug is used for conditions other than cancer.

It is used more than 48 hours after cancer treatment or is not a full replacement for intravenous treatment.
Parenteral Nutrition (administered by infusion)If you cannot absorb nutrition through your intestines.If used for reasons other than a digestive track that does not work.

Read More: What Should I Do If I Am Having Trouble Accessing My Medication?
Learn About: How Does Medicare Cover Prescription Drugs?
Return to: Medicare Part D

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