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Medicare Part D again
Old 11-03-2019, 01:29 PM   #1
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Medicare Part D again

Questions, possibly stupid: I am researching part D, having decided to apply for Parts A and B, and a state retiree supplement. (Supplement from another state than current residence, and supplement does not cover "over Medicare payment charges." Those are illegal in this state, so I think I am good there.) It does not include prescriptions, so I need part D. Currently taking two drugs, a tier 2 and 3. Not so worried about them, but some of the part D plans say chemo is not covered. Yet that seems to be part of the 6 protected classes of drugs. I don't need it now, but having had many cancers due to a genetic mutation, cannot assume I have seen the end of that. So what is true--can they or not, exclude chemo drugs? I was already perplexed enough with trying to figure out where I hid my crystal ball to let me know that drugs I will need in the future, but this is worse! Thanks.
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Old 11-03-2019, 01:40 PM   #2
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Since you can change Part D plans every year and you don't currently take any chemo drugs it is somewhat of a non-starter issue in my book and you should base your decision on your current drug regimen.
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Old 11-03-2019, 01:43 PM   #3
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Most chemo would be covered under Parts A and B not D. There might be some oral agents under D though so read carefully.
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Old 11-03-2019, 01:53 PM   #4
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Quote:
Originally Posted by palomalou View Post
Questions, possibly stupid: I am researching part D, having decided to apply for Parts A and B, and a state retiree supplement. (Supplement from another state than current residence, and supplement does not cover "over Medicare payment charges." Those are illegal in this state, so I think I am good there.) It does not include prescriptions, so I need part D. Currently taking two drugs, a tier 2 and 3. Not so worried about them, but some of the part D plans say chemo is not covered. Yet that seems to be part of the 6 protected classes of drugs. I don't need it now, but having had many cancers due to a genetic mutation, cannot assume I have seen the end of that. So what is true--can they or not, exclude chemo drugs? I was already perplexed enough with trying to figure out where I hid my crystal ball to let me know that drugs I will need in the future, but this is worse! Thanks.
Chemo is usually covered by part B because it is administered in a doctor’s office.
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Old 11-03-2019, 04:47 PM   #5
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Old 11-03-2019, 05:03 PM   #6
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My wife is a rather high maintenance person--when it comes to medicines. And she has a $1200 per month Tier III medicine that we end up paying about $265 for.

We went with a more expensive Part D option as she'll end up going into the donut hole pretty quick with her meds. Thankfully, most are generic, but one of the expensive ones will tear up one's pocketbook easily.
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Old 11-04-2019, 05:29 AM   #7
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Medicare Publication on Coverage of Cancer Treatment: https://www.medicare.gov/Pubs/pdf/11...t-Services.pdf

Quote:
Part A covers: Inpatient hospital stays, including cancer treatments you get while you’re an inpatient in the hospital.

Part B covers:
• Many chemotherapy drugs that are administered through your vein in an outpatient clinic or a doctor’s office.
• Some oral chemotherapy treatments.
• Radiation treatments given in an outpatient clinic

These cancer drugs may be covered under Part D:
• Prescription drugs for chemotherapy only available to be taken by mouth
• Anti-nausea drugs
• Other prescription drugs used in the course of your cancer treatment, like pain medication
If an oral anti-cancer drug was previously only available in injectable form, the oral version is also Part B.
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