What You Need to Know About Medicare Coverage on Over-the-Counter Drugs
One question often asked by people who are looking for drug assistance programs is “What if I have Medicare Part D?” The answer isn’t always straightforward as there are some things you should know in detail about your Medicare coverage specifically on Over-the-Counter Drugs (OTC). Let’s take a closer look at what medication expenses might be covered under your Medicare plan and which ones could cost you.
Medicare Part B
Medical Insurance or Medicare Part B can cover limited drug coverage; however, it does not cover most of the medications you can buy at the pharmacy.
What Medicare Part B covers:
- Injections at a doctor or a health care provider’s office
- Certain Oral Cancer medications
- Drugs used in certain medical equipment such as a nebulizer
- Certain medication you get in an outpatient setting in hospitals or health care facilities
- Flu and Pneumococcal shots
Medicare covers 80% of the Medicare-approved bill for the covered drugs. For certain vaccines such as shingles vaccine, Medicare Drug Plans can cover them.
Medicare Part B
Get Started with Your Medicare Advantage Plan
Medicare Part C
Medicare Part C or Medicare Advantage Plan may cover allowances for over-the-counter drugs. However, it is important to note that these plans’ benefits and availability can vary. It is therefore important to compare different Medicare Advantage Plans in your location that specifically allows coverages for OTC drugs.
Medicare Advantage Over-the-Counter Drug Card
A Medicare Advantage Over-the-Counter Drug Card or OTC Card helps you cover the costs when buying OTC medications. Since it is similar to a prepaid card (but for OTC drugs and other health products), it is best to check with your insurance carrier what eligible products you can purchase as well as how you can check your drug card balance and reload credits.
Most Medicare Advantage OTC Drug Card policies include the following:
- Flu medication
- Cold and cough medication
- Pain Relievers
- First-aid care materials
- Antibiotics
- Digestive medication
- Sleep aids
- Orthopedic support products
- Denture-care products
For an in-depth catalog of benefits, contact your plan provider.
Medicare Part D
Medicare Part D or the Medicare Prescription Drug Coverage covers most outpatient prescribed drugs and they can be offered through private companies as stand-alone plans (if enrolled in the Original Medicare) or as a Medicare Advantage Plan benefit.
However, it does not cover over-the-counter drugs, alongside fertility drugs, weight loss & weight gain drugs, cold and cough relief, medication for erectile dysfunction, prescribed vitamins and minerals (except for prenatal vitamins), and drugs for cosmetic purposes such as hair growth (some treatment drugs for psoriasis, vitiligo, and acne may be covered under Part D).
Most vaccines are covered by Medicare Part D, except for those that are already covered in Medicare Part B.
As the population ages, it is important for all of us to be aware of Medicare’s coverage policies and how they may change over time. It is vital that individuals understand what they are entitled to under their plan as well as any possible limitations or exclusions. Our team at Evolve can help provide you with all the information that you need to make informed decisions when choosing a plan that can specifically cover OTC drugs that will suit your needs. Contact us at (800) 805-4439 today!