What can I do if my medication is not covered?

Updated on: October 24, 2018

Originally posted on: August 7, 2015

If you’ve been prescribed a medicine that is not on your Part D plan’s formulary (list of covered drugs), you can ask that your plan to cover it by requesting an exception to the formulary. This is the first step in a coverage determination. Your doctor will need to explain in writing the medical reasons why you need to take this drug. If your plan denies coverage, you can then file an appeal for the plan to reconsider its decision.