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Navigating Medicare drug coverage: Part B vs. Part D.

Authors: Kevin B, Piper;

Navigating Medicare drug coverage: Part B vs. Part D.

Abstract

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.

Keywords

Medicare Part B, Insurance, Pharmaceutical Services, Medicare, United States

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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