@pocojack Well, I was at Mayo for a conference last week, and I asked one of the pharmacists in attendance why this is such a difficult issue for those of us on Medicare.
He said several things - one was that with the complexity of Medicare regulations, there is a highly specific "path" to follow - Rx for nebulizer, another covered inhalant and 7% saline - all under Medicare, then the 7% saline and the other inhaled Rx are both covered under Part B. Miss one of those, and many insurers balk, making the pharmacies reluctant to deal with them. Usually what happens is the pharmacy you use doesn't handle nebulizers, so it comes from somewhere else, and you miss one leg of the stool.

The other thing he said is that, technically, since 7% saline does not require a prescription, Medicare is not required to cover it. An analogy would be when they cover a CPAP machine, which is durable medical equipment, but not the distilled water to use in it, because it is not an Rx item.

So, welcome again to the Wild, Wild West of modern medical coverage. I guess it depends how persistent your pharmacist is, and how savvy in using exactly the right codes for every piece of the puzzle.

Sue