Medicare — Coverage, Limitations & Opportunity

Medicare is a big patient population, but coverage for home infusion is narrow. Understanding the difference between Part B and Part D is key when talking to a referral source about a Medicare patient.

When a referral source asks about a Medicare patient, always clarify: Is this a pump-based drug (Part B) or a specialty pharmacy drug (Part D)? That determines the benefit, the billing, and the authorization requirements. Getting this right upfront prevents delays.