Guide to Medicare Part D: What If My Part D Plan Removes My Drug From Its Formulary?
This page is part of our Guide to Medicare Part D.Your Part D plan must provide written notice to you at least 60 days prior to the effective date of the change in its formulary.
If your Part D plan fails to provide you with written notice of a change in its formulary, it must provide you with a 60-day supply of your drug.
| NOTE: Your Part D plan cannot change its formulary from November 15 - March 3 of each year. |
If your Part D plan fails to provide you with written notice of a change in its formulary, and refuses to provide you with a 60-day supply of your drug, contact your nearest Kentucky legal services program.
If you receive notice from your Part D plan, or otherwise find out about formulary change that affects you, contact your doctor.
Explain to your doctor that your drug is no longer on your Part D plan's formulary. 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.