If you have a Medicare Part D prescription drug plan, every year you receive a booklet that lists all of the prescription drugs that your plan covers. What happens if the medication you take is no longer covered?
Every year Medicare prescription plans change which drugs they will cover. Notice of any changes usually comes in the form of a booklet that lists all of the covered drugs for the calendar year. This leaves many seniors wondering what happens if their plans stop covering one of their medications or if they switch plans to one that does not cover their medications.
Recently, Elder Law Answers offered some answers in "Your Right to Refills If Medicare Drops Coverage of Your Drugs."
The good news is that you will not suddenly find yourself without insurance coverage for the medications you need. Within the first 90 days of joining a new plan or the new contract year of an existing plan, coverage must be given for a 30-day supply of any ongoing prescription.
Consequently, that means you have 30 days to visit with your doctor to have a substitute medication prescribed that is covered by your plan.
Alternatively, you can apply for a coverage exception for your current medication. If you do, prescription refills must be supplied until your exception request is ruled on.
If you are in a nursing home, you have even more coverage. Refill requests for all 31-day supplies must be honored for 90 days after the switch in coverage.
If you have questions about Medicare prescription coverage or other Medicare issues, consult with an elder law attorney.
Reference: Elder Law Answers (Feb. 11, 2016) "Your Right to Refills If Medicare Drops Coverage of Your Drugs."