How to Respond to a Medicare Part D Denial

When you need to have your drugs paid for by Medicare Part D to be able to make your finances work it can be incredibly frustrating when you are denied.  This may seem like an impossibility as your doctor should know what drugs are not covered by Medicare Part D, but it does happen.  However, you do have the right to appeal the decision and you have options if this does not work.

Once your drug is denied by Medicare Part D you will receive a “Notice of Denial of Medicare Prescription Drug Coverage” in the mail.  This form will list what has been denied and why along with other useful information.  This information will show you how to appeal the decision that was made not to pay for your Medicare Part D drugs.

If the appeal is not successful and it is finally decided that your drug is not covered you should return to your doctor.  Ask your doctor if it is possible that you could take another drug to treat your condition that Medicare Part D does offer.  If this works you are in the clear, if not, you should consider pushing the issue with Medicare a bit further.

One Response to How to Respond to a Medicare Part D Denial

  • Judy Sieg says:

    I am compliling a resource guide for the aging in my church community. I need to include the information on the Medicare process in the the resource guide.

    Can you send me a complete electronic file on this information?

    Can you mail me a paper copy of the medicare process and application process so we can include it in the resource guide?

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