A question we get a lot from our clients:
“I understand that Part D is prescription drug coverage. But I know Part B covers some medications too. How do I know which medications are covered under which Part?”
This is a valid question! It’s always nice to know where your monthly premiums are going and what they’re covering.
To help simplify things and make them memorable, let me propose a little pneumonic device:
Part B = Bedside (these are drugs that are usually administered bedside, like at a doctor’s office or an infusion center. Sometimes they are administered by durable medical equipment that has been covered under Part B, i.e., insulin via a Part B-issued insulin pump)
Part D = DIY (Part D covers what most people think of when they think of an Rx: a bottle you pick up from the pharmacy and take at home – no need for a physician administering here).
I’ll give some examples of each:
Part B Covered Medications:
- Vaccinations (Full list HERE)
- Some antigens
- Blood clotting factors
- Injectable and infused drugs
- Injectable osteoporosis drugs
- Oral end-stage renal disease drugs
- Transplant and immunosuppressive drugs
- Drugs used with an item of durable medical equipment
- Oral Cancer Drugs
- Insulin
- The new Alzheimer’s drug, Leqembi
Part D Covered Medications (all Part D plans must cover at least two drugs from most categories and at least two for each of these categories):
- HIV/AIDS treatments.
- Antidepressants.
- Antipsychotic medications.
- Anticonvulsive treatments for seizure disorders.
- Immunosuppressant drugs.
- Anticancer drugs (unless covered by Part B)
Of course, each Part D plan has its own formulary (a.k.a. list of drugs it covers). It is helpful to reach out to an agent if you need help finding a Part D plan that covers the drugs you need at the most competitive price.
I hope this was helpful to you! Remember, Part B covers drugs administered Bedside (physician-administered) and Part D covers drugs that are DIY (you take yourself).