Medicare Prescription Drug Plan Change

I thought this was not covered by Medicare. I’ve been using GoodRX

@cwal Had Medicare been paying for your 7% saline....it appears it had?????
Barbara

I didn't get a letter, but my Kaiser medicare plan has been covering the saline. I am going back onto Original Medicare starting Jan 1, and when I was signing up for Part D prescription plan, I was informed that Medicare would not cover the saline.

It has not been covering my saline at all. The rules say only if it is used to mix in with something … I guess like a powder or concrete of some sort. Good RX is the best price I’ve found but it varies from pharmacy.

@bernadene24 @paxmundi Just last night I thought about those of you coming off of the Kaiser Plan because from what I understand they will cover and pay for the saline and the aerobika etc., If I have understood a couple of you on the Kaiser Plan.
It is true, Original Medicare will not pay for saline nor the aerobika. Kaiser in its plan may cover things that will not be covered in the Original Medicare nor the Plan D.
The important thing with the Original Medicare and Supplement is that you can go anywhere in the U.S. for medical care, (great if you need a facility closer to family etc.) in financial terms in a way you (and I) are paying, (via the premium) in advance for large billing medical care and therefore you know in advance your costs for the year and no billing surprises. With the plan you gain more paid days if needed in a hospital/rehab facility when needed. Most of the Advantage Plans have you paying large sums (deductible) each year if you need to use it in various ways...like a hospital stay etc.
Always a tradeoff.
Barbara

I was told that Medicare Part B, not Part D, would pay for 7% saline if you got your nebulizer through Medicare. However, I’ve been trying for over a month to get this at CVS. They told me I must have a prescription from doctor with diagnosis on it. It can’t be the PA who sends it. I have still not gotten it despite them saying at NYU that they sent it. Now I’m thinking just to forget it if Medicare Part B says they won’t cover. I’ve been ordering from Amazon, Respease, in the meantime. Wish I could figure this out since will be using forever most likely.

@sharonednaramsey concentrate not concrete🤪

@wandafanda They omitted a few details. You must also have a prescription for a Rx only med like albuterol or budesonide. And the pharmacy must sell nebulizers. And they must be under contract to sell nebulizers. In my state, CVS does not contract to sell nebulizers, so cannot cover saline.

@positivethinking
You are correct. It's confusing at best. I have a Medicare Advantage plan provided and managed by my former employer. Starting in the new year there will be a different insurer that they contracted with for medical care but no changes in coverage provided. So, same coverage but different provider. My saline has always been covered at zero cost so I was confused when I got the letter from the new provider. I called and spoke with them and the person I spoke with could not answer the question either. She suggested I get my physician to send a pre-authorization form to put on file for when the new coverage actually starts. I guess I won't have an answer for certain until then.

@cwal after reading the comments I gathered this was covered under an advantage plan, not traditional Medicare like I have. Thanks for clarifying