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Medicare AdvantageCoverageMedium impact

MA08.007ap, Medicare Part B vs. Part D Crossover Drugs

Independence Blue Cross·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

This is a general informational update regarding Medicare Part B vs. Part D crossover drugs for Medicare Advantage plans. The policy provides guidelines on how to handle pharmacy benefits that may be covered under either Medicare Part B or Part D.

Action Required

Action needed
By January 15, 2025: Billing team should review the updated Medicare Advantage crossover drug guidelines to ensure proper billing distinctions between Part B and Part D pharmacy claims. Verify billing software is configured to route drug claims to the appropriate Medicare benefit category based on the updated policy guidance.