Frequently Asked Questions
Questions You May Have Regarding Medicare, Your Medication and Supplies

Will the cost of my medication be covered by my insurance and/or Medicare?

Yes, if one of the following situations apply:

  • The patient has a primary and secondary commercial/private insurance (double coverage); or
  • The patient has Medicare along with either a supplemental policy or secondary insurance
  • The patient has Medicare and qualifies for a financial waiver per the Medicare guidelines. In this case, we will bill the patient, then the patient must call to request an application for the financial waiver. At that time, we work with the patient to determine waiver eligibility.

Will Medicare pay for my medications and supplies?

The national Medicare program does reimburse for certain medication used by persons in their home. There are specific medical conditions which must be reported by the prescribing doctor and other qualifications a person must meet.

In general, Medicare covers respiratory medicines administered by a compressor nebulizer. When covered, Medicare pays 80% of a price established by the government. The remaining 20% is the responsibility of the patient, and often a private insurance program such as a “supplemental policy”, will pay the remainder.

ABC Plus ‘accepts assignment’, which means we complete all the paperwork and bill Medicare and insurance companies for you.

Will Medicare pay for my metered dose inhaler (MDI)?

At this time, ABC Plus is a Medicare Part B only provider, which does NOT provide reimbursement/coverage for respiratory medications via MDI’s.

If I do not have a secondary or supplemental insurance, will I owe the remaining 20%?

Yes. Medicare requires providers to bill and collect your share of the prescription cost.  If you are financially unable to afford your share, the Medicare program does allow waivers.

Please request a financial waiver form and call our Customer Service Department at 1-800-638-6305 to speak with our reimbursement specialists for more information.

Can you ship more medication when I need it?

Yes. We can send a 30 or 90-day supply at one time. In order to send a 90-day supply, the physician must write a prescription for a 90-day supply, and the patient must request a 90-day supply. Pharmacies are also restricted by the prescription your physician provided you; it must be refillable. If you are using more medicine each day than prescribed, you will need to check with your physician. We must check with your physician before we can increase the amount of medication dispensed to you.

If I cannot use the medication or I do not need anymore, can I return it?

No. We cannot take back medicine that has been ordered. Federal law prohibits returning medication once it has been dispensed.

Why do I receive two plastic nebulizers with my medication?

With proper cleaning and care, each disposable nebulizer should last two weeks. We know some individuals continue to use them beyond the recommended two week period. However, they are made to be disposable and their effectiveness does diminish over time.

Do I really have to take my medication 3 to 4 times each day?

Many of the respiratory medications only last a few hours in your body and must be taken as prescribed to be effective. It is very important to take your medication as prescribed. Your doctor understands your situation best and you should speak with him or her. You may also call us at 1-800-638-6305 to speak with one of our Registered Pharmacists concerning any question you may have about your medication.