Medicare Part D Question

Apr 25, 2016

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  1. Nikita
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    Nikita Guru

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    If someone had Part A only, and they are admitted to the hospital, does the Part A cover any prescription medicines they are given while they are an in-patient or would they have to have Part D to get the medicines covered?
     
    Nikita, Apr 25, 2016
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  2. XpressInsurance
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    XpressInsurance Super Genius

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    Yes, as a rule part D pays only for medicine picked up at the pharmacy
     
  3. BeeSelective
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    BeeSelective Guru

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    It appears "self administered" drugs in the hospital are no longer covered under Medicare? If you take, for example, simvastatin and lisinopril at home and are given it in the hospital, Medicare does not cover it and you are billed at some outrageous cost. Anyone seen this or is our hospital ,,,lifepoint, just nuts?
     
  4. kgmom219
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    kgmom219 What's Next?

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    1. Was the client admitted to the hospital as inpatient or "Under Observation"? (This is critical)
    2. Based on the info, I would assume client was Under Observation. Oral meds that are administered while Under Observation are covered under Part D, not A or B. Client is able to submit for reimbursement.

    How I explain it to clients during the sale...."Unless you know you are being admitted, you need to take your prescriptions with you to the hospital, in the original container. If you can't do that, try and make sure to have someone bring them to you. Otherwise, the hospital is going to charge you $20 for a single pill. And your Part D plan will send you a reimbursement check for $.10 cents."

    They may still get hit with a bill, but at least you already told them about it....
     
    kgmom219, Apr 25, 2016
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  5. somarco
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    somarco GA Medicare Expert

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    I could be wrong but I don't think the hospital allows self-administered drugs due to liability concerns.
     
    somarco, Apr 26, 2016
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  6. kgmom219
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    kgmom219 What's Next?

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    I've done it twice now with my parents in the ER and gotten zero pushback. I think the nurses know what the issue is.
     
    kgmom219, Apr 26, 2016
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  7. XpressInsurance
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    XpressInsurance Super Genius

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    "I've done it twice now with my parents in the ER and gotten zero pushback. I think the nurses know what the issue is. "


    I can see this with certain meds, like blood pressure, statins & diabetes meds, but I don't think hospital would like patients to bring in their own pain killers.
     
  8. somarco
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    somarco GA Medicare Expert

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    Pills brought to you by the nurse are not self administered. The nurse cannot swallow them for you.

    If you would rather the nurse assist, she can treat them like a suppository.

    Those are definitely not self administered.
     
    somarco, Apr 26, 2016
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  9. goillini52
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    goillini52 KeepAmericaGreat...Eat Bacon & BUILD THAT WALL!!!

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    Yikes...I wouldn't want a nurse sticking pills up my butt!!!:no:
     
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