What if my drug is not on my Medicare Part D plan's formulary?

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First, contact your doctor.

Explain to your doctor that your Medicare Part D plan refused to cover your drug because it was not on its formulary. Find out whether your doctor will prescribe a substitute drug that is on your Medicare Part D plan's formulary.

If your doctor believes that you must have the prescribed drug, then ask your doctor to contact your Medicare 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 the Medicare Part D Unit at
Legal Services for the Elderly at
1-877-774-7772
.

Get more information about requesting an Exception.