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Does Medicare pay for Prescription Drugs?

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Does Medicare pay for Prescription Drugs?

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Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. You should call your Durable Medical Equipment Regional Carrier for more information. There are some Medicare Health Plans that cover prescription drugs. You can also check into getting a Medigap or supplemental insurance policy for prescription drug coverage. Medicaid may also help pay for prescription drugs for people who are eligible.

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Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases such as immunosuppressive drugs for transplant patients and some oral anti-cancer drugs. Medicare also covers certain prescription drugs used in nebulizers and external infusion pumps. If you get Medicare covered prescription drugs, make sure your pharmacy or supplier is enrolled in the Medicare Program. If you go to a pharmacy that is not enrolled, Medicare will not pay. You will be responsible for paying the entire bill. Under current law, all Medicare enrolled pharmacies must accept assignment for Medicare covered drugs and biologicals. If you purchase these items from a Medicare-enrolled pharmacy or supplier, you should only pay your 20% co-pay (and any remaining Medicare Part B deductible) when you get your prescription or supplies. Medicare will pay the remaining 80% directly to the pharmacy or supplier after they submit the claim. Many Medicare Advantage plans

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Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. You should call your Durable Medical Equipment Regional Carrier for more information. Check the Important Phone Numbers page for contact information. There are some Medicare Health Plans that cover prescription drugs. You can also check into getting a Medigap or supplemental insurance policy for prescription drug coverage. Medicaid may also help pay for prescription drugs for people who are eligible.

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If you want prescription drug coverage through Medicare, you have to join a Medicare Prescription Drug Plan, or a Medicare Advantage or other Health Plan that offers this coverage, such as a Medicare HMO. These plans cost extra. Standard Medicare coverage (Part B) does not cover prescription drugs except in a few cases, like certain cancer drugs. Enrollment in a Medicare Part D Prescription Drug Plan is voluntary. Medicare prescription drug coverage is sold by private insurance companies and costs extra. Different companies offer different plans. Monthly premiums and covered drugs vary from one plan to another. Prescription Drug Plans have monthly premiums, annual deductibles, coinsurance/copayments, and a coverage gap. People with low or moderate income can get Extra Help from Social Security or from Prescription Advantage to help pay these costs. For information about prescription drug coverage, see Medicare Prescription Drug Plans.

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As of August 2002, Medicare does not cover prescription drugs. However, in certain cases Medicare does cover some drugs, including immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. Prescription drug benefits for Medicare enrollees are the subject of intense debate in the U.S. Congress, and changes to the Medicare policy are likely. Check back with www.ALZinfo.org periodically for updates on this, or sign up for an email alert service to receive notices about updates. To learn about prescription drug benefit programs that you might be eligible for, please visit www.medicare.gov and follow the links for “Prescription Drug Assistance Programs.” You can use the search tool at that site to find programs in your area.

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