Medicare Advantage - Prescription Drugs That Are Injected At A Doctor’s Office

Many, but not all, Medicare Advantage plans include prescription drugs at no additional premium. 

Medicare Advantage plans that do include Part D prescription drugs may have some caveats, with regards to member’s out of pocket costs, when it comes to getting certain types of injections at at doctor’s office. Depending on how the doctor’s office bills the shot, the member’s out of pocket expense could be a big shock to them. Some prescription drugs can be billed under different parts of Medicare (including any Medicare Advantage plan that includes prescription drug coverage.)

It is important to ask BEFORE having a shot at a physician’s office whether the shot will be billed under Part B or Part D. If billed under Part B, the member’s out of pocket expense could be 20%! Which could be a lot more expensive than the Part D Tier level out of pocket expense a member thought it was going to be for that same drug. Out of pocket costs to the member can be ambitious for different type shots/drugs. So it is important to do the research of how much your out of pocket expense will be before you have the injection at a provider’s office! I highly suggest you talk to your doctor’s office in advance of getting your Osteoporosis (or other type) shot and find out what your out of pocket costs will be.

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

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