Q & A
I didn’t change my Medicare prescription drug plan, but now some of my medications are not covered by my 2014 plan — even though they were covered by my plan last year. What can I do?
Answer: There are three steps you can take if your medications are not covered by your 2014 Medicare Part D plan. (1) If your medication is still a part of the Medicare program, you can ask your Medicare prescription drug plan for a one-time, 30-day transition or temporary supply of your medication. (2) While you are using the temporary supply, you and your physician can seek an alternative drug included on your plan’s formulary. (3) You can file a formulary exception (or coverage determination) with your Medicare Part D plan requesting that your non-formulary medication be covered under your 2014 Medicare plan.
Remember that if your formulary exception request is denied, you have the right to appeal your plan’s decision a number of times and you can contact your vendor for an overview of the appeals process.
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Source: Margaret Beck, Redding.com/news/2014 – January 11, 2014