Table 2.

Medicare Coverage for Immunosuppression: Myths and Realities

MythReality
Medicare is moving immunosuppression coverage from Part B to Part D.Immunosuppression remains a Part B benefit for recipients who have a Medicare-covered transplant.
Part D will pick up some or all of the 20% co-insurance for immunosuppression.Parts B and D are separate programs that do not work together to share costs for any Medicare-covered drugs.
Pharmacies can bill immunosuppression to Part D if the patient does not have Part B or does not have a supplement to cover the 20% co-insuranceAlthough there are many verified reports of Part D plans covering immunosuppression in these instances, they do so in error for any patient who had a Medicare-covered transplant.
State Medicaid programs no longer pick up the 20% co-insurance for "dual eligibles" (those with Medicare and Medicaid).Fee-for-service Medicaid or State Qualified Medicare Beneficiary programs remain responsible for Part B co-insurance for dual-eligible patients.