Part B or Part D

Apr 18, 2019

  1. New kid
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    Hello everyone,

    Newer agent here. I have a client Medicare effective 05/01 this year, she is taking "humira" - very expensive drug. (She is injecting herself). Since the drug is $5k/mo, will this drug be covered under Medicare part B (we are talking about getting a supplement) or Part D?
    Thank you,
     
    New kid, Apr 18, 2019
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  2. DS4
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    Part D. The good news? Your client will be in the catastrophic phase after 1 Rx
     
    Last edited: Apr 19, 2019
    DS4, Apr 19, 2019
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  3. somarco
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    somarco GA Medicare Expert

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    If she can't qualify for Extra Help or a PAP she can ask her doc about generic drugs
    Rheumatoid Arthritis Medications - GoodRx

    I have a client with RA that takes plaquenil.

    I also understand that autoimmune disease comes in various forms and med's that work for one person may not do the same for another.

    Just offering some suggestions you might want to pass along.
     
    somarco, Apr 19, 2019
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  4. fed up
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    AbbVie has rebates and discounts available for Humira. some Pharmacists will bill as "No Coverage" which will make eligible for huge savings.
     
    fed up, Apr 19, 2019
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  5. LostDollar
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    LostDollar Guru

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    Old discussions mentioned Mark's Marine Pharmacy as an option for insulin. Might also apply to Humira.

    (I have no idea how this compares to the Part D catastrophic coverage-just wanted you to have the idea in the event you would find it helpful for one of your clients in the future.)
     
    Last edited: Apr 19, 2019
  6. kstein
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    Also you can bring up infusions as those are covered under Part B .

    Cimzia and remicaid are 2 popular ones
     
    kstein, Apr 19, 2019
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  7. Todd King
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    Todd King IMO/FMO Owner

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    If it was a drug administered in the doctor's office, it would likely be covered under Part B. Otherwise it is part D.
     
  8. JustinTime
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