Prescription drugs (outpatient)

Examples of Part B-covered drugs:

• Monoclonal antibodies for treating early Alzheimer’s Disease
• Drugs used with some types of durable medical equipment (DME) : If the drug used is medically necessary , Medicare covers certain drugs infused through Part-B covered DME (like an infusion pump).
• Some antigen allergy tests and treatments: Medicare covers some antigen tests to check for and treat allergies if a doctor or other health care provider prepares them, and they're given by a properly instructed person (who could be you, the patient) under appropriate supervision.
• HIV prevention drugs.
• Injectable osteoporosis drugs.
• Erythropoiesis-stimulating agents: Medicare covers erythropoietin by injection if you have  End-Stage Renal Disease (ESRD) or you need this drug to treat anemia related to certain other conditions.
• Blood clotting factors: If you have hemophilia (a genetic bleeding disorder that keeps your blood from clotting properly), Medicare covers injectable clotting factors you give yourself or get in a doctor's office.
• Injectable and infused drugs: Medicare covers most injectable and infused drugs when a licensed medical provider gives them.
• Oral End-Stage Renal Disease (ESRD) drugs: Part B covers  ESRD drugs you take buy mouth.

• Intravenous Immune Globulin (IVIG): Medicare covers IVIG you get at home if both of these conditions apply:
  • You've been diagnosed with primary immune deficiency disease.
  • Your health care provider decides that it's medically appropriate for you.
    
    Part B also pays for other items and services related to you getting  IVIG at home.
• Vaccines: Medicare covers flu, pneumococcal and COVID-19 vaccines. Medicare also covers some other vaccines when they're directly related to treating an injury or illness.
• Immunosuppressive drugs: : If Medicare helped pay for your organ transplant, Part B covers transplant drug therapy (including standard and  compounded immunosuppressive drugs) to prevent organ rejection.   You must have Part A at the time of the covered transplant, and you must have Part B at the time you get immunosuppressive drugs.

• Oral cancer drugs: Medicare covers some cancer drugs you take by mouth if the same drug is available in an injectable form, or it's a prodrug of the injectable drug. A prodrug (an oral form of the injectable drug that breaks down into the same active ingredient after you take it.)
• Oral anti-nausea drugs: Medicare covers anti-nausea drugs you take by mouth if you take them before, during, or within 48 hours of getting chemotherapy treatment for cancer, or you get them as full therapeutic replacement for an intravenous anti-nausea drug.

Usually, Part B covers drugs you wouldn't typically give to yourself, like those you get at a doctor's office or in a hospital outpatient setting.

Medicare drug coverage (Part D) covers many drugs that Part B doesn't cover. If you have Original Medicare, you can join a Medicare drug plan to get Medicare drug coverage. If you join a drug plan, check your plan's drug list (also called a formulary) to find out what outpatient drugs it covers.

Part D generally covers all adult vaccines that the Advisory Committee on Immunization Practices (ACIP) recommends, including vaccines for Respiratory Syncytial Virus (RSV), shingles, whooping cough, measles, and more. Your drug plan won’t charge you a copayment or deductible for vaccines that ACIP recommends. Talk to your provider about which ones are right for you.