I will be starting Medicare in January 2023 and need to know if part D will cover biologic DMARDS in case my RA worsens and my rheumatologist prescribes it for me or if I will need a Plan G Medigap plan to go with it. Anyone taking a biologic currently that has traditional Medicare? I'm not going with a Medicare Advantage plan.
Certain drugs are injections, others are infusions. Some are both. Patient does not usually decide.
I guess you will figure out what to take and how to take it when the times. Hopefully, it won't be insurance driven.
I have Medicare A , B, and Aetna Medicare supplement. I get Rituxan 1000mg biologic infusions 4 per year and I’ve been fortunate they are all 💯 covered I have no copay, thank God, the cost is over $200,000.00 a year
Your being proactive on selecting coverage for your specific needs is the best way to go!
Just an FYI biologic infusion is covered under your Medicare and supplement NOT prescription plan
Thanks for the quick answer. I'm going to find out eventually (I hope!). I have a year to do it.
I am on Medicare for disability. I chose to also stay with my private insurance from my previous job. Medicare is my primary and the other is secondary for medical insurance. However, i chose to use my private insurance for prescriptions and not Medicare. The reason was because I am on a biologic and I heard that it is hard to get them on Medicare. I am not 100% sure though. Biologics are very expensive and every pharmaceutical company with a copay assistance card, to help pay for the drug, always ask if I have private prescription drug insurance. Since I do, I always get help paying for the copay for the biologics. I am not sure how it works with Medicare. I'm curious to find out.
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