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.
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!