Does Medicare Pay For Reclast?

Question

Asked by Sondra

Does Medicare Pay For Reclast?

Answer

Hi Sondra: I've talked to several people that say MC pays 80% of reclast under the part B (not D) provisions of MC, if you have the original MC plan. If you have an HMO, through MC, then the coverage price (copay) may vary some.

To be sure that you are covered, you'd have to call MC at 1-800 Medicare (1-800- 633-4227) and double check that you plan does cover this, or your HMO provider if you have one. There may be some variations between the type of plan you have and your location, so call and ask if this is covered. Since reclast is administered via an infusion at a hospital or infusion center, it's would fall under your part B coverage, not the prescription benefit, which is part D. On the Reclast web site they say that MC covers this, but I would call and ask anyway, plus the web site has other important numbers for info on this. Also your Dr., the one ordering the treatment, should know if you are covered based on his or her experience billing this.

Good luck with this and I hope it helps tremendously.