Medicare Part D

Know Your Coverage Under Medicare Part D

If you purchase a Medicare Part D prescription drug plan, it’s important to understand your coverage and costs.

To ensure US citizens have adequate coverage, Medicare has established guidelines and procedures that Part D plans must follow to make sure you receive the services provided under the law. These practices also protect you against unethical practices.

As a Part D beneficiary, you have the right to:

• Request that a plan cover a medication your doctor believes is medically necessary
• Request lower cost sharing or out-of-pocket costs if your provider feels that lower tier (less expensive) alternatives are inappropriate versus your newly prescribed drug
• Obtain a timely decision as to whether the plan will cover and pay for the product (usually within 72 hours)
• Receive a detailed explanation of a plan’s coverage decision
• Appeal coverage denials

Learn more about your Medicare Part D coverage at Medicare.gov.