Does Medicare Cover Humira?

Medicare Part B does cover Humira when your doctor administers the injection. If you self-administer Humira, you must buy it through your Medicare Part D prescription drug plan. By purchasing Humira and other prescription drugs through a Part D plan, you could enter the donut hole and have large out-of-pocket expenses.

When you enter the Part D donut hole, MedicareBob advises you have your doctor administer Humira to reduce your Part D out-of-pocket cost. In this Medigap Monday video, Robert Bache explains how you can get Humira for FREE with a Medicare Supplement Plan.

Medicare Part B covers Humira

Drugs covered by Part B usually are not self-administered but provided by your doctor’s office or hospital outpatient. Some drugs covered by Part B include:

  • Medications that use durable medical equipment – such as an infusion pump or a nebulizer. 
  • Injectible (Humira) and infused drugs when given by a licensed medical provider
  • Shots (vaccinations) such as flu shots, Hepatitis B shots, etc.

Furthermore, Part B covers transplant / immunosuppressive drug therapy and other drugs.

Does Medicare Cover Humira
Doctor administers Humira injection

How your Medicare Supplement covers Humira

In MedicareBob’s video, Robert’s client takes Humira because she has Rheumatoid Arthritis. She orders Humira from her Part D provider. Eight months later, the client is now in the Part D donut hole. As a result, the client’s prescription drug costs have increased. 

Then MedicareBob gives the client a tip. Instead of ordering prescription drugs through Part D plan, you can go to a doctor’s office and have the doctor administer it for you. Then Medicare will bill doctor’s visit as Part B service. Original Medicare pays 80%, and your Medicare Supplement pays the other 20%. Thus, you can get Humira for FREE! 

Does Medicare Cover Humira