Does Medicare Part B Cover Prescription Drugs? What’s Covered and What You Pay
Reviewed October 1, 2026. Medicare Part B covers only a limited list of prescription drugs, mostly medications a doctor or nurse gives you in an office, clinic or hospital outpatient setting, such as infusions and injections. It doesn’t cover the pills you pick up at the pharmacy for everyday conditions; those are covered by Medicare Part D or a Medicare Advantage plan with drug coverage. For Part B drugs, you generally pay 20% of the Medicare-approved amount after the Part B deductible, which is $283 in 2026.
Quick answer: Part B pays for drugs that are part of medical care, like chemotherapy infusions, injectable osteoporosis drugs for eligible women, certain vaccines, drugs used with an infusion pump, and some oral cancer and anti-nausea drugs. Most self-administered prescriptions, like blood pressure pills, statins or inhalers, need Part D. Insulin used in a Part B-covered pump costs no more than $35 for a month’s supply.
What does Medicare Part B cover for prescription drugs?
Medicare.gov describes Part B drug coverage as “a limited number of outpatient prescription drugs.” The covered categories are:
- Injectable and infused drugs that a licensed medical provider gives you, which covers most drugs given in a doctor’s office or hospital outpatient department
- Drugs used with durable medical equipment, such as certain drugs infused through a Part B-covered infusion pump or nebulizer
- Some antigens (allergy shots and tests) prepared by a provider
- Injectable osteoporosis drugs for women who meet Medicare’s criteria
- Erythropoiesis-stimulating agents for people with End-Stage Renal Disease (ESRD) or anemia related to certain conditions
- Blood clotting factors for people with hemophilia
- Oral ESRD drugs such as calcimimetics and phosphate binders
- Immunosuppressive drugs after a Medicare-covered organ transplant
- Oral cancer drugs when the same drug is available in injectable form, or is a prodrug of it
- Oral anti-nausea drugs used as part of a chemotherapy regimen
- Intravenous immune globulin (IVIG) provided at home for primary immune deficiency
- HIV pre-exposure prophylaxis (PrEP) drugs
- Monoclonal antibodies for early Alzheimer’s disease
- Vaccines including flu, pneumococcal, COVID-19 and hepatitis B, plus vaccines directly related to treating an injury or illness
Source: Medicare.gov, Prescription drugs (outpatient).
Does Part B cover the prescriptions I fill at a pharmacy?
Usually not. Medications you take on your own at home, like metformin, lisinopril, atorvastatin or an albuterol inhaler, fall under Part D. Part B pays for a pharmacy-dispensed drug only when it’s on Part B’s list, for example certain oral cancer or anti-nausea drugs, transplant drugs, or drugs used with Part B equipment. If you have Original Medicare and no Part D plan, you’d pay full price for most pharmacy prescriptions.
How much do Part B drugs cost in 2026?
| Cost | What you pay with Original Medicare (2026) |
|---|---|
| Part B premium | $202.90 per month (standard amount; higher with IRMAA) |
| Part B deductible | $283 per year |
| Most Part B drugs | 20% of the Medicare-approved amount after the deductible |
| Hospital outpatient setting | 20% coinsurance plus a facility copayment may apply |
| Insulin used in a Part B-covered pump | No more than $35 for a one-month supply, and no deductible |
| Flu, pneumococcal, COVID-19 and hepatitis B vaccines | $0 when the provider accepts assignment; the deductible doesn’t apply |
| Immunosuppressive drug coverage only (Part B-ID) | $121.60 premium per month and $283 deductible |
Sources: CMS, 2026 Medicare Parts A and B premiums and deductibles; Medicare.gov, Insulin. More on the deductible: Medicare Part B deductible.
There’s no yearly cap on what you pay for Part B drugs under Original Medicare. With expensive infusions, such as some cancer, rheumatoid arthritis or Alzheimer’s drugs, 20% coinsurance can add up quickly. That’s why many people pair Original Medicare with a Medigap policy or choose a Medicare Advantage plan, which has a yearly out-of-pocket maximum.
Can Part B coinsurance be less than 20%?
Sometimes. Under the Inflation Reduction Act, if the price of certain Part B drugs rises faster than inflation, your coinsurance for those drugs can be lower than 20% for that quarter. CMS publishes the list of affected drugs each quarter, and the reduced amount is applied automatically when the claim is processed.
Part B vs. Part D drug coverage
| Part B | Part D | |
|---|---|---|
| Who gives the drug | Usually a provider, in an office, clinic, dialysis facility or hospital outpatient department | You take it yourself, filled at a pharmacy or by mail |
| Examples | Chemotherapy infusions, osteoporosis injections given by a provider, IVIG, drugs in a pump | Pills for blood pressure, cholesterol, diabetes, depression; most inhalers and insulin pens |
| How you get it | Comes with Part B | A stand-alone drug plan or a Medicare Advantage plan with drug coverage |
| Cost sharing | 20% coinsurance after the $283 deductible (2026) | Plan copays or coinsurance; deductible up to $615 in 2026 and $700 in 2027 |
| Yearly out-of-pocket cap | None under Original Medicare | $2,100 in 2026 and $2,400 in 2027 |
Part D figures come from Medicare.gov, How much does Medicare drug coverage cost? To see how Part D costs move through the year, read Medicare Part D drug coverage phases.
Why the same drug can be Part B or Part D
Coverage depends on how and why a drug is given, not only on the drug’s name. Insulin is a good example: Part B covers insulin used in a Part B-covered insulin pump, while insulin pens, syringes and patch pumps fall under Part D. Some vaccines work the same way. Flu, pneumococcal, COVID-19 and hepatitis B shots are Part B, while shingles and Tdap vaccines are covered under Part D. See which vaccines Medicare covers for the full breakdown.
Part B drugs with Medigap or Medicare Advantage
Medigap: A Medicare Supplement policy can pay some or all of your 20% Part B coinsurance, including for infusions. With Plan G, for example, you typically pay only the Part B deductible each year for covered Part B drugs. Medigap doesn’t cover Part D drugs. Compare letters in what Medigap plans cover.
Medicare Advantage: Medicare Advantage plans must cover every drug Original Medicare covers under Part B. They set their own copays or coinsurance, may require prior authorization or “step therapy” for some Part B drugs, and count Part B drug costs toward the plan’s yearly out-of-pocket maximum. If you’re comparing plans for 2027 during Open Enrollment (October 15 to December 7, 2026), check each plan’s “Medicare Part B drugs” line in its Summary of Benefits.
Common examples
- Remicade (infliximab) infusions given in a clinic are usually Part B. See Does Medicare pay for Remicade infusions?
- IVIG at home for primary immune deficiency is Part B; other IVIG uses may fall under Part B or Part D depending on the setting. Help with costs: IVIG copay assistance for Medicare patients.
- Chemotherapy given in a clinic or hospital outpatient department is Part B. Read Medicare and cancer patients.
- Eye injections for wet age-related macular degeneration given by an eye doctor are Part B.
- Nebulizer medications like albuterol solution used with a Part B-covered nebulizer can be Part B, while an albuterol inhaler is Part D.
How to check whether your drug is Part B or Part D
- Ask the prescriber’s office how the drug will be given and billed. Offices that give infusions handle Part B billing every day.
- Search your Part D plan’s formulary. Some drugs are marked “B/D,” meaning the plan decides based on how the drug is used.
- Call your plan using the number on your member card, or call 1-800-MEDICARE (1-800-633-4227).
- Review your Medicare Summary Notice or plan Explanation of Benefits to see how a claim was paid.
Frequently asked questions
Does Medicare Part B cover prescriptions?
Only some. Part B covers a limited list of outpatient drugs, mostly those given by a provider, plus specific categories like transplant drugs, certain oral cancer drugs and some vaccines. Most prescriptions you fill at a pharmacy need Part D.
Is Part B drug coverage included automatically?
Yes. If you have Part B, its drug coverage comes with it. You don’t sign up for it separately. Part D, by contrast, is a separate plan you choose, and enrolling late can mean a Part D late enrollment penalty.
What do I pay for a drug covered by Part B?
Usually 20% of the Medicare-approved amount after the $283 Part B deductible in 2026. Insulin used in a Part B pump is capped at $35 for a month’s supply, and the flu, pneumococcal, COVID-19 and hepatitis B vaccines cost $0 when the provider accepts assignment.
Does Part B cover insulin?
Only insulin used with a Part B-covered insulin pump. Insulin pens, vials used with syringes and patch pumps are covered under Part D. Either way, your cost is no more than $35 for a one-month supply of each covered insulin product.
Can I get Part B drug coverage without Part D?
Yes. Part B drug coverage is part of Part B. But without Part D or other creditable drug coverage, you’d have no coverage for most pharmacy prescriptions, and you may owe a penalty if you enroll in Part D later.
This article is general information, not medical or individual insurance advice. Medicare365 is not affiliated with or endorsed by the U.S. government or the federal Medicare program.