FPGEE for National Association of Boards of Pharmacy (NABP) Practice Exam

What are the limitations of coverage under Medicare Part B for prescription drugs?

1. Unlimited coverage for any prescription

2. Very limited coverage, including specific cancer-related treatments

3. No coverage whatsoever

4. Coverage only for over-the-counter medications

The correct answer is: Very limited coverage, including specific cancer-related treatments

Medicare Part B primarily covers medically necessary services and supplies, including some outpatient prescription drugs, but it does have limitations. The correct answer highlights that coverage under Medicare Part B is very limited, particularly for specific situations such as cancer-related treatments. This aspect emphasizes that while certain prescription drugs may be covered, it is typically only those that are used as part of a medical service, like chemotherapy drugs administered in a healthcare setting. For example, Medicare Part B covers certain injected or infused medications, those that are part of a patient's overall care plan, and some specific categories of drugs that are deemed necessary for treating particular conditions. However, most outpatient prescription drugs that one might obtain at a pharmacy typically fall under Medicare Part D rather than Part B. The other options, while depicting varying degrees of coverage, do not accurately reflect the realities of Medicare Part B. Unlimited coverage does not exist; it is carefully regulated. Complete lack of coverage is inaccurate because there is some coverage for certain drugs when used in specific contexts. Lastly, coverage for over-the-counter medications is also not a function of Part B, further reinforcing the accuracy of recognizing the specified limited coverage focus regarding prescription drugs associated with medically necessary treatments.