Henry Ford Health | Pharmacy

Medicare Part B Billing

Medicare Part B Billing

Many of your Henry Ford pharmacies can bill your eligible prescriptions as a medical benefit through Medicare Part B and your qualified supplemental insurance. Eligibility to bill Medicare Part B is dependent on your medical condition and medication.

You must meet the following criteria to qualify and have active coverage through Medicare Part B or Part C 

Criteria for Transplant Medication:

  • You must have had active Medicare Part A or Part C coverage at the time of transplant and Medicare Part A or Part C must have paid toward your transplant.
  • You must have a transplant diagnosis

Criteria for Nebulizer Medication:

  • Your diagnosis must be approved by Medicare for the prescribed drug
  • You must own or rent a nebulizer machine

Criteria for Insulin:

  • You must be receiving your insulin through an insulin pump

Criteria Oncology Medication:

  • Your diagnosis code must be approved by Medicare for the prescribed drug

Other Important Information:

  • The Medicare Part B annual deductible as of 2023 is $226.00
  • Medicare Part B will cover 80% of the cost of your medication and leave you with a 20% coinsurance unless you are insured by a supplement plan.
  • Your Part C plan may have a coinsurance or deductible, please refer to your insurance handbook.
  • Copays for insulin billed to Medicare Part-B will not exceed $35 for a 30-day supply