
One of the gray areas of Medicare Part D coverage is determining when a prescription falls under Part D and when it falls under Part B. Most Part B drug spending is for drugs billed by a physician and provided incident to the physician's services for a Medicare patient. Medicare Part D medications are dispensed via a prescription and are usually self-administered. Here are examples of situational rules that determine whether a patient is covered under Part B or Part D. Many situations exist where a particular drug for a specific patient is covered under both Part B and Part D, albeit with different delivery and cost-sharing aspects. Understanding which applies when is important to gaining access to medically necessary prescriptions for patients. Giving this information to the prescription plan when writing a prescription order will assure that the medication is provided efficiently, rather than having to deal with denials and an appeal process.
Medicare Part B, Insurance, Pharmaceutical Services, Medicare, United States
Medicare Part B, Insurance, Pharmaceutical Services, Medicare, United States
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