BC Advantage - 2006 Issue 11

Part D Coverage Determinations

In order for physicians to avoid coverage clarification calls for drugs prescribed to Medicare beneficiaries, they should learn the differences in coverage rules in Part B and Part D for the medications that they routinely prescribe. Part B covers a few outpatient drugs:Drugs that are not self-administered IV or injectable drugs administered as part of a physician service Drugs administered via durable medical equipment Immunosuppresive drugs for covered transplants Clotting factors for hemophiliacs Antigens IVIg provided in the home Some oral anti-emetic and chemotherapeutic drugs Erythropoeitin for end stage renal disease Some preventive vaccines such as pneumococcal pneumonia Parenteral...

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