Medicare has and continues to pay for certain drugs under Part B. The accompanying table provides a quick and easy reference guide for the most frequent B/D coverage scenarios. It does not address all potential situations.

If you are prescribed a drug that is included in the categories below, it may require authorization from us so we can determine which part of Medicare covers it. Please call us at the Customer Service number on your ID card and request an authorization. If your medicine is covered under your medical benefit, it will be provided to you by our contracting provider, Option Med.

Medicare’s website includes a database you can search to learn more about coverage issues. Or you can call Medicare for more information.

www.medicare.gov
(800) MEDICARE
TTY/TDD: (877) 486-2048
24 hours a day, 7 days a week

Medicine Categories that Require Authoriztaion	B or D Coverage?
Drugs requiring use of a device such as a pump (e.g., inhalation drugs used with a nebulizer, such as albuterol, ipratropium, Xopenex and insulin via infusion pump) NOTE: Only for beneficiaries residing in their homes.	Part B
Drugs used in immunosuppressive therapy for beneficiaries who received a transplant from a Medicare-approved facility and were entitled to Medicare Part A at time of transplant (e.g., Azathioprine, Cellcept, Cyclosporine, Gengraf, Imuran, Myfortic, Neoral, Orthoclone Okt3, Prograf, Rapamune, Sandimmune, Simulect, Zenapax)	Part B for Medicare-covered transplant Part D for all other situations
Select oral drugs used for cancer treatment (e.g., Alkeran, Myleran, Temodar, VePesid, Xeloda)	Part B for cancer treatment Part D for all other indications
Oral anti-nausea drugs within 48 hours of chemotherapy treatment (e.g., Anzemet, Emend, Kytril, Zofran)	Part B within 48 hours of chemo Part D for all other situations
Erythropoietin (EPO) for chronic renal failure and dialysis (e.g., Aranesp, Epogen, Procrit)	Part B if undergoing dialysis Part D for all other situations