Can a drug be covered under both Part B and Part D?
Asked by: Ena Kemmer | Last update: January 5, 2026Score: 4.5/5 (69 votes)
Can a drug be covered under part B and Part D?
Some drugs may be covered by either Part B or by Part D, depending on the situation. For example, if you use an insulin pump, you probably get your insulin and pump from a durable medical equipment supplier, and Part B will cover it. If you inject insulin using a needle, Part D will cover it.
Can you have Medicare Part B and D?
You can get your Part B medical coverage through your former employer, through a standalone plan, or directly from Medicare. To enroll in Medicare Part D, you must already have either Medicare Part A or Part B. You pay a Part B premium to Medicare every month.
What is a dual eligible Part D plan?
Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care and wrap-around services for dual eligible beneficiaries (eligible for both Medicare and Medicaid).
Can you have more than one prescription drug plan?
If you have more than one prescription drug plan and plan to use Coordination of Benefits, it's important to make sure the pharmacy has the processing information for both plans. It's also important to make sure the pharmacy is aware which plan is considered primary and which plan is considered secondary.
How Medicare Part D Works (2025)
Can you be on two healthcare plans?
Having two health plans doesn't mean you'll receive full medical coverage twice. Instead, one policy will be your primary plan, and the other will be your secondary health coverage. This ensures the total amount your two plans will pay for your health expenses will never exceed 100% of the cost of those expenses.
Can you get two items on one prescription?
Multiple prescription charges are payable where on the same prescription: • Different drugs, types of dressings or appliances; including those ordered with extra parts are supplied; • Different formulations or presentations of the same drug or preparation are prescribed and supplied; • Additional parts are supplied ...
What is the dual complete plan?
UnitedHealthcare Dual Complete plans
This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.
Is Medicare Part D mandatory?
Enrollment in Part D is generally voluntary, however, some people are required to be enrolled, and others should not enroll.
How do you qualify for dual eligibility?
- You are enrolled in Original Medicare (Part A, Part B, or both); and.
- Receive full Medicaid benefits; or.
- Get help with your Medicare out-of-pocket costs through a Medicare Savings Program (MSP)
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Who qualifies for an extra $144 added to their Social Security?
To qualify to get $144 added back to your Social Security check, you can enroll in a Medicare Advantage plan that offers a Part B premium reduction or giveback benefit.
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
What is the most popular Part D drug plan?
The best Medicare Part D provider is Aetna. It has top ratings from the Centers for Medicare & Medicaid Services and affordable premiums. Other great providers include Wellcare and UnitedHealthcare.
Does Medicare Part B cover eye exams?
Original Medicare ( Part A and Part B ) doesn't cover eye exams or other vision-related costs, except for special situations. However, some people on Medicare have options, including vision coverage through individual insurance or Medicare Advantage plans (Part C) with vision coverage.
How much does Medicare Part B pay for physician fees?
Medicare pays 80% of the approved charge. Either the patient or supplemental insurance pays the remaining 20% co-payment. No further payment is due to the physician. When a physician does not accept assignment, however, he or she may “balance bill” the patient above the Medicare approved charge.
What are disadvantages of Medicare Part D?
Disadvantages of Medicare Part D Prescription Drug plans include: Need to anticipate your prescription drug needs for the year: Part D plans differ in the types of drugs they cover. Knowing your medical situation can help you select a plan that is right for you and covers the prescription drugs you expect to need.
What is the $2000 limit for Medicare Part D?
Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.
What happens if I refuse Medicare Part D?
If you don't sign up for a Part D plan when you are first eligible to do so, and you decide later you want to sign up, you will be required to pay a late enrollment penalty equal to 1% of the national average premium amount for every month you didn't have coverage as good as the standard Part D benefit.
What is dual coverage?
Revised 09/06/2024. People who are entitled to both Medicare and Medicaid, also known as dually eligible individuals, fall into several eligibility groups. These individuals may either be enrolled first in Medicare and then qualify for Medicaid or vice versa.
Is dual complete Medicare an advantage?
A Dual Special Needs Plan is a special kind of Medicare Advantage coordinated-care plan. It is an all-in-one plan that combines your Medicare Part A and Part B benefits, your Medicare Part D prescription drug coverage, your Medicaid benefits and additional health benefits such as vision, dental or fitness.
Can you have Medicare and UnitedHealthcare at the same time?
Most UnitedHealthcare dual-eligible plans do not charge a separate monthly premium. People eligible for Medicare may also qualify for the program that helps lower the cost of prescription drugs. The Extra Help program may help pay your Medicare Part D monthly premiums, annual deductibles, and prescription copayments.
Can you get prescriptions from two different pharmacies?
Using multiple pharmacies is common among many patients these days, especially older patients who take multiple medications. While getting prescriptions from different pharmacies can have some benefits—such as cost savings on certain medications—using multiple pharmacies may lead to dangerous consequences.
Who is exempt from Prescription charges?
You are 16, 17 or 18 and in full-time education. You are pregnant or have had a baby in the last 12 months and have a valid maternity exemption certificate. You have a valid medical exemption certificate. You hold a valid War Pension exemption certificate, and the prescription is for your disability.
What is the 28 day prescription rule for controlled substances?
It refers to the number of days you may need to wait between refills of 30-day prescriptions that are considered controlled substances. If you have a medication that follows the 28-day rule on a 30-day supply, it means you can get a refill no earlier than 2 days before the 30 days are up.