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What to do When a Medication Isn’t Covered by Medicare Part D

December 4, 2015 by John Bush

Sometimes you may be prescribed a medication which is not covered on the formulary, which is a list of covered medications, for your Part D Prescription Drug Plan. What can you do?

  • Ask your doctor if there is an alternative medication which is on the formulary for your Part D Prescription Drug Plan.
  • If the particular medication is not on the formulary, contact your Part D Prescription Drug Plan and request a formulary exception to get it covered.
  • Pay for the medication out-of-pocket. If the medication is expensive you might want to contact the manufacturer to see if there is an assistance program to help off-set the cost of the medication.
    • Check www.needymeds.com
    • Check www.goodrx.com 

Have a question on your plan? Don’t hesitate to contact Senior Savings Services at 1-800-592-0819.

Category iconMedicare Part D - Prescription Drug Plan Tag iconMedicare,  Part D,  Prescription Drug Plan

About the Author

John Bush has been an independent insurance broker helping those on Medicare learn of their rights and options since 2010. He has helped many people find the right plan that is best for them. John is passionate about helping people in a manner that is easy to understand, resourceful, and non-pushy. John helps people get the best coverage for their premium dollar without sacrificing customer service.

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