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Medicare part b vs part d insurance coverage

Medicare Part B vs. Part D: Prescription Drug Coverage Options

To ensure you can age independently and without financial burden, having Medicare drug coverage is a must.

The average annual cost of a name brand drug used to treat a chronic condition was $5,800 as of 2016. The costs are only getting larger, and seniors who struggle to afford their prescriptions avoid filling them or skip doses.

Being enrolled in Medicare drug coverage can save you thousands of dollars a year. Having a plan in place will give you peace of mind that you will be able to take drugs you need to maintain or improve your quality of life.

So should you stick with a Medicare Part B, or should you look at Medicare Part D?

This post will help you make an informed decision.


Medicare Part B – Drug Coverage and Benefits

Medicare Part B is part of the original Medicare, and you need to pay a premium for it. It covers outpatient expenses that Part A does not, such as doctor and specialist visits, vaccines, medical equipment, and some preventative tests and screenings.

Part B does cover some drugs, but with limited conditions. Most of the drugs covered by Part B are drugs that you do not administer yourself and would not get at a pharmacy.


What Drugs Does Medicare Part B Cover?

  • Drugs designed to be used with medical equipment
  • Osteoporosis drugs (injectable)
  • Erythropoiesis-stimulating agents
  • Blood clotting agents
  • Oral end-stage renal disease (ESRD)
  • Intravenous nutrition
  • Intravenous immune globulin
  • Vaccinations directly related to the treatment of injury or illness
  • Drugs required for an organ transplant

You can view a comprehensive list of the types of what drugs are covered by Medicare Part B on the Medicare website.


Medicare Part D – Drug Coverage and Benefits

Medicare Part D provides coverage for prescription drugs from a pharmacy. Only private insurance plans provide Part D, and you need to be already enrolled in Basic Medicare to enroll. Along with paying monthly premiums, each prescription will also have a copayment or coinsurance:

  • Copayment: When you pay out of pocket a set dollar amount (ie. $15)
  • Coinsurance: When you pay a percentage of the drug cost out of pocket (ie. 25%)


What Drugs Are Covered by Medicare Part D?

Every Medicare plan will have its own list of covered drugs. This is known as a formulary. By law, a Medicare D plan must cover at least 2 drugs (name brand and generic) for every category and class. This ensures all medical conditions are represented.

Covered drugs in the same category will often be assigned tiers, with the cheapest, generic forms of drugs on the lowest tier vs. brand name. Drugs in the lowest tier are subject to a smaller copayment/coinsurance.

It is important to make sure you do your research on different Part D plans to ensure their coverage suits your needs.

Learn more about how Medicare Part D plans work on the Medicare website.


Medicare Part B vs Medicare Part D – How to Choose

Medicare Part B only covers your drugs in the event of a hospital stay or outpatient care. If you want a comprehensive drug plan in the event you end up needing multiple prescriptions, you need Medicare Part D.

It is important to note that Medicare Part B is included in Medicare Part C, or Medicare Advantage. Many Medicare Advantage plans cover Part D as well. These private insurance plans not only provide the stand benefits of Medicare Part A, B, and D but also other benefits such as vision, dental and fitness reimbursement.

Medicare plans can also be supplemented by Medicaid if you are eligible.

Not every Medicare Advantage plan is the same, however.

At Call4SeniorSavings, we provide seniors with comparison quotes tailored to your unique needs from the top Medicare providers in the U.S.

To speak to one of our agents and let them do your Medicare comparison research for you, reach out to us today.

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