Medicare Drug Coverage
Under Medicare Part A (inpatient), drugs are covered when provided during acute inpatient stays if Medicare requirements are met. Under Medicare Part B (outpatient, Emergency Room, observation hospital surgery stays), drug coverage is limited to drugs that are not usually self-administered.
During the course of outpatient treatment, you may be given medication Medicare considers self-administered. Medicare defines self-administered drugs as medication the patient could, in another setting, take him or herself.
Medications brought from home in their original pharmacy container, properly labeled and positively identified may be used with a physician order. If we are able to use your home medications, you will not receive a bill for these medications. So when coming to the hospital for outpatient admission, to see a physician, receive outpatient services or use the Emergency Room, always try to bring any medication (in its original pharmacy container) you have been taking.
In order to remain compliant with Medicare regulations related to the billing of these drugs, the hospital is required to submit these self-administered drugs as non-covered items on our billing to Medicare. You will receive a bill from the hospital following payment of our claim by Medicare. In addition to any deductible and co-insurance due, this bill will reflect the charges for unpaid self-administered drugs.
If you have questions, you may call our Business Office: (517) 437-8398. If you would like additional information about your coverage by Medicare, you can call: 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov to get help with your Medicare questions.