OT: Medicare and hospital pharmacy

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chunkyfrog
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OT: Medicare and hospital pharmacy

Post by chunkyfrog » Tue Apr 28, 2015 5:40 pm

I find that while I am in the hospital, my daily meds MUST come from the hospital pharmacy.
Does Medicare limit what they can charge? Or it it a free-for all, compliments of the patient?
The "self-administered" drugs are covered under Part D, and I'm too close to that ugly donut hole!
I've been looking until my tablet gets hot, anybody have a link?

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LSAT
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Re: OT: Medicare and hospital pharmacy

Post by LSAT » Tue Apr 28, 2015 5:52 pm

From my experience in a Medicare Advantage plan, I was not charged anything for my entire hospital stay except for a daily co pay.
My surgery expenses, surgeons,doctors, CTs, meds, PT, etc were all covered. For a 5 day stay, I paid $250 per day...that's all . The total bills before insurance were over $80k. (insurance paid...about $28k)
Last edited by LSAT on Tue Apr 28, 2015 8:03 pm, edited 1 time in total.

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Pugsy
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Re: OT: Medicare and hospital pharmacy

Post by Pugsy » Tue Apr 28, 2015 6:01 pm

Hospital stays come under the Medicare Part A coverage. Anything they do or give you administered by the staff is included in the hospital bill. This includes the meds they dispense to you. It's all under Part A and the amounts billed are no where near what is actually allowed or paid. You pay (or your supplemental insurance) only the Part A deductible.

Medicare Advantage plans are a little different in terms of patient's responsibility but (depends on the plan) but the same principle will apply in that meds are part of the overall bill and the patient's responsibility is limited to whatever the contract/plan they have.

The hospital doesn't get anywhere near what they bill for the meds they administer.

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chunkyfrog
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Re: OT: Medicare and hospital pharmacy

Post by chunkyfrog » Tue Apr 28, 2015 6:04 pm

I hope so. Even the Medicare folks are clueless.

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Re: OT: Medicare and hospital pharmacy

Post by OkyDoky » Tue Apr 28, 2015 6:08 pm

chunkyfrog wrote:I hope so. Even the Medicare folks are clueless.
Here is a PDF I found that states covered under part A from what I read. https://www.cms.gov/Regulations-and-Gui ... 102c01.pdf
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Re: OT: Medicare and hospital pharmacy

Post by chunkyfrog » Tue Apr 28, 2015 6:15 pm

Thank you, I have made a bookmark.

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Re: OT: Medicare and hospital pharmacy

Post by chunkyfrog » Tue Apr 28, 2015 6:34 pm

Another thing, the PDF is dated June, 2014. Hope it hasn't been superceded yet.

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Re: OT: Medicare and hospital pharmacy

Post by chunkyfrog » Tue Apr 28, 2015 8:47 pm

Oh, fudge! The cancer surgeon's office says I'll be an inpatient,
but the reconstructive surgeon has me down as an OUTpatient!
More phone calls!

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Krelvin
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Re: OT: Medicare and hospital pharmacy

Post by Krelvin » Tue Apr 28, 2015 9:02 pm

chunkyfrog wrote:Oh, fudge! The cancer surgeon's office says I'll be an inpatient,
but the reconstructive surgeon has me down as an OUTpatient!
More phone calls!
Frog splitting time.
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Re: OT: Medicare and hospital pharmacy

Post by palerider » Tue Apr 28, 2015 9:07 pm

Krelvin wrote:
chunkyfrog wrote:Oh, fudge! The cancer surgeon's office says I'll be an inpatient,
but the reconstructive surgeon has me down as an OUTpatient!
More phone calls!
Frog splitting time.
HEY! lay off the frog!

no splitty the frog!

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