Insurance Agent Forum
Custom Search
 

Go Back   Insurance Agent Forum > Insurance Agents and Brokers Forum > Senior Insurance Forum


Discussion on Where can I research Part B drugs? within the Senior Insurance Forum, part of the Insurance Agents and Brokers Forum category.

I need to know for sure if Humira is covered under Medicare Part B. It used to be injected in ...


Reply to Where can I research Part B drugs?
Views: 153 - Replies: 15  
LinkBack Thread Tools Search this Thread Display Modes
Old 07-23-2008, 04:29 PM   #1
Guru
 
Newby on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Apr 2007
Location: Southern Indiana/ Kentucky border
Posts:899
Newby is on a distinguished road
Where can I research Part B drugs?             Go to Top

I need to know for sure if Humira is covered under Medicare Part B. It used to be injected in the doctor's office but now it is self injected at home.

What about Remicade which is given as an IV in a medical facility.

Where can I research the Medicare Part B covered drugs?


Newby is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 04:57 PM   #2
Guru
 
Join Date: Apr 2007
Location: Michigan
Posts:268
insurance0707 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

You can go to medicare's website or you can google does Medicare Part B cover Humira. Googling has helped me many times to find the answer fast.


insurance0707 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 05:06 PM   #3
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

I googled humira and medicare and part b and 2008 and came up with lots of info. For instance:

Abbott Lab's statement regarding the CMS announcement on medicare demonstration project for self-injectable drugs


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 07:20 PM   #4
Guru
 
MedSuppPro on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Sep 2007
Posts:277
MedSuppPro is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Watch dates of google search results as June 2004 is pre PartD. Since PartD -- no more free HUMIRA. Good luck finding a PartD plan that works for HUMIRA.


MedSuppPro is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 08:00 PM   #5
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Humira is listed in the forumularies. PA and QL, as is Remicade.

That is why I included the 2008 in my search. The Humira and Remicade seem to both be Part B covered if for a medicare approved treatment and done in a Drs office or Hospital.


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 08:50 PM   #6
Guru
 
Join Date: Apr 2007
Location: Michigan
Posts:268
insurance0707 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Here's another great program...Humira has a patient assistance program where you may be able to get it for free. There is another program listed that looks like it's disease based for Cronans (however you spell it) where you may be able to get it for free due to the health condition. here's the link...

Program


insurance0707 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 10:21 PM   #7
Guru
 
MedSuppPro on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Sep 2007
Posts:277
MedSuppPro is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Patches36: It may be that you Googled ... + 2008. However, your article is dated 2004. This means it is 4 years old. A lot of Medicare rules have happened since then.

insurance0707: I have not had any sucsess with HUMIRA + PartD + Pharmaceutical Assistance Program. I also don't see this drug adminitered in a clinics neither.



Last edited by MedSuppPro : 07-23-2008 at 10:37 PM. Reason: Contents may not be reproduced in any form
MedSuppPro is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 10:52 PM   #8
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

oops. thanks.


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-23-2008, 11:42 PM   #9
Guru
 
Newby on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Apr 2007
Location: Southern Indiana/ Kentucky border
Posts:899
Newby is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

I guess from reading this page from the Remicade web site (updated 01/22/2008) I can take from this that it is covered by Medicare Part B Plus a Med Sup Plan D would cover the bal after the deductible?
Remicade


Newby is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 09:02 AM   #10
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

In the formulary I read it is covered by Part D, but with PA (Prior Authorization). So, there are hoops to jump through.


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 10:10 AM   #11
Guru
 
Newby on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Apr 2007
Location: Southern Indiana/ Kentucky border
Posts:899
Newby is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Quote:
Originally Posted by patch36 View Post
In the formulary I read it is covered by Part D, but with PA (Prior Authorization). So, there are hoops to jump through.
I need you to dumb that down for me a little bit. Does that mean it is no longer covered by part B? Where can I read this myself? Is it on Medicare's website? Is there a link?


Newby is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 10:58 AM   #12
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

That is from the Humana Drug Formulary. Every PDP company has a formulary and I have not looked in any others to confirm if they also cover the drugs and have that policy. Prior Authorization means the pharmacy and the Dr will have to get involved with the insurer.

Whether a drug is covered by a PDP or not has nothing to do with Part B, which includes Hospitial and Dr administered Drugs.

Call a Dr. office and hospital billing department and ask them about part B coverage for Remicade and Humira.

Google, search Medicare.gov, ect.


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 11:35 AM   #13
Guru
 
Join Date: Apr 2007
Location: Michigan
Posts:268
insurance0707 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

patch is right. The doctor's office prescribing the medication will usually know if this medication is covered under Part D or Part B because they're the one's usually doing the billing


insurance0707 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 12:56 PM   #14
Guru
 
Newby on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Apr 2007
Location: Southern Indiana/ Kentucky border
Posts:899
Newby is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

The doctor's office didn't give her a definite answer.

I called the drug manufacturer today. They said it is still covered under Medicare part B if her arthritis is one of the listed types that it is approved for. I am going to have the doctors office call them and discuss her exact condition to get the answer straight from the source. It appears like it will be covered.

Thanks everyone for their help. Some of this can get confusing.


Newby is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-24-2008, 01:11 PM   #15
Guru
 
patch36 on Where can I research Part B drugs? - Insurance Agent Forum
 
Join Date: Jul 2008
Location: MO
Posts:689
patch36 is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Humira and Remicade are both used for off label and experimental treatments and this will affect whether the PDP Part D or Part B will cover them. You are on the right track.


patch36 is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Old 07-26-2008, 01:10 PM   #16
Guru
 
Join Date: Jan 2007
Location: Kansas
Posts:865
retread is on a distinguished road
Re: Where can I research Part B drugs?             Go to Top

Quote:
Originally Posted by Newby View Post
I need you to dumb that down for me a little bit. Does that mean it is no longer covered by part B? Where can I read this myself? Is it on Medicare's website? Is there a link?
Some drugs that are on Part D formularys may be administered in the doctor's office. When this is done, they are considered Part B benefits. This can be a two-edged sword, but in many cases can save the client some big bucks for hi $ drugs that can be administered by IV or injection.

Also, I tried without success to get Medicare to give me an answer on some specific Part B drugs. They just drive you around in circles and won't respond to your question directly. Best advice is get the info from the doctor's office.


------------------------------------
Think you have guts? Committment? Consider this British Light Brigade during the Crimean war, when 1/3rd of them didn't come back alive:
Theirs not to make reply,
Theirs not to reason why,
Theirs but to do & die,
Into the valley of Death
Rode the six hundred.

Cannon to right of them,
Cannon to left of them,
Cannon in front of them
Volley'd & thunder'd;
Storm'd at with shot and shell,
Boldly they rode and well,
Into the jaws of Death,
Into the mouth of Hell
Rode the six hundred.
retread is offline  

Submit to Reddit Submit to Del.icio.us
Bookmark to TechnoratiSubmit to FurlSubmit to Spurl!
Reply With Quote
Reply to Where can I research Part B drugs?

  Insurance Agent Forum > Insurance Agents and Brokers Forum > Senior Insurance Forum

Tags: ,



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Similar Threads for: Where can I research Part B drugs?
Thread Thread Starter Forum Replies Last Post
Do your research before you work for American Income Life Jane General Insurance Agent Discussions 6 10-24-2008 07:03 PM
Do your research before you work for American Income Life Jane Life Insurance Forum 6 05-01-2008 11:14 PM
Part B drugs? Winter Senior Insurance Forum 7 01-07-2008 01:21 PM
Purchasing Drugs Outside of U.S. salpro22 Individual Health Insurance Forum 11 07-21-2007 03:49 PM



Register Now for FREE!