Your Health

Understanding Medicare Reimbursement and Claims

Medicare Part D

Medicare part D covers prescription medications. It is provided through private insurance plans. You can find out which medications are covered by reading the rules in each plan, which are called a formulary. The amount of money you need to pay depends on a tier system, such as specialty drugs, brand, generic. Claims will be filed for covered drugs by the pharmacy where you purchase them. However, you still have to pay coinsurance and copayment. It is possible to file a Medicare claim when you make a payment for medication yourself.  [5]