Guide to Medicare Part D: What If I Can't Get My Drug Because My Doctor Did Not Obtain Prior Authorization From My Part D Plan?
This page is part of our Guide to Medicare Part D.First, contact your doctor. Explain to your doctor that your Part D plan refused to cover your drug because he/she did not obtain prior authorization. Find out whether your doctor will prescribe a substitute drug that is on your Part D plan's formulary.
If your doctor believes that you must have the prescribed drug, then ask your doctor to contact your Part D plan to request an "Exception" and to explain why your drug is medically necessary.
| NOTE: You have a RIGHT to request an Exception.
For questions or advice, contact |
Get more information about requesting an Exception.
Reviewed August 2009
This online guide was adapted with permission from Maine Legal Services for the Elderly. We extend our thanks to them.