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