Part B is your medical coverage. Part D is your pharmacy coverage. However, depending on the type of medications you receive and where you receive them, there are times when you will need to use your medical coverage for prescriptions and pharmacy-related items.

Original Medicare
Part B Medical Insurance

  • Medical service
  • Outpatient care
  • Medical items

Items that may be covered by Medicare Part B, and not Part D:

  • Certain medications (commonly referred to as Part B drugs)
  • Durable medical equipment
  • Specialty pharmacy
  • Mail-order pharmacy

Part B

Part B is your Medical coverage. This part pays for things like doctor visits, lab tests and home health care.

Medicare requires that certain medications and durable medical equipment (like diabetic test strips, nebulizers and wheelchairs) be covered under Part B.

You may receive your Part B medical coverage through your former employer, through a stand alone plan or directly from Medicare.

You need to pay a Part B premium to Medicare every month.

Remember, just because you can purchase an item at a pharmacy does not mean it is covered by your prescription plan, however health supplies or equipment may be covered by the medical part of your Medicare plan, Part B.

Part D

Part D is your pharmacy (or medications) coverage. This part pays for the medications you may take regularly to manage for example, heart disease, high cholesterol or asthma, or for medications you may take for a short time such as antibiotics.

Many retail pharmacies cannot bill a medical plan for Medicare medical prescriptions (commonly referred to as Part B drugs) or medical equipment.

If you need Part B drugs or medical equipment, ask if your pharmacy is able to bill your medical plan directly. Or consider using these types of specialty service providers:

  • Medical equipment
  • Home infusion
  • Home health care
  • Specialty pharmacy
  • Medical specialty service
  • Mail order pharmacy

If you need help finding a specialty provider, contact us.

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