Medicare beneficiaries occasionally need “self-administered medications” when they are patients in hospital outpatient departments. These are drugs that you would typically administer yourself, such as those for managing blood pressure or diabetes. For the most part, Medicare Part B usually does not cover the cost of self-administered drugs in outpatient hospital settings.
When you’re in an outpatient department, the hospital might bill you for any self-administered medications that aren’t included in Part B coverage. If you have a Medicare prescription drug plan (Part D), you might have coverage for these medications.
Here are several points to consider about Medicare prescription drug plans (Part D) and self-administered medications:
– Medicare prescription drug plans often exclude coverage for over-the-counter drugs like pain relievers or stool softeners.
– A prescription drug under your Medicare drug plan is only eligible for coverage if it’s included in the plan’s formulary (a list of covered drugs), unless an exception applies.
– It’s not typical to receive your self-administered medications in outpatient or emergency department environments on a regular basis.
Explore further about the Coverage of Self-Administered
Drugs in Hospital Outpatient Departments by Medicare here.
