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 Q&A - Learn what to do if you cannot find a medication covered in a prescription drug plan

What is Medicare-Question
What should I do if I can’t find one of my medications on any drug plan’s formulary?


Answer to What is Medicare question
A Part D drug plan does not cover every medication....
 

In many cases, medications not covered are brand name drugs with a cost-effective generic option available. A physician can provide guidance on another drug that may work just as well.

If a person cannot take the generic version of a drug, a physician can request a formulary exception from the drug plan. The doctor must submit a written statement indicating that the non-formulary drug is necessary because all covered Part D drugs would not work as effectively or would have adverse effects. A drug plan’s Evidence of Coverage should explain the procedure for requesting an exception.

One more thing:  When choosing a plan, look for one that covers all your medications. 

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Last updated: 12-21-2012