Are prescription drugs and medications covered under the law?
• A. Yes. The claimant should send a receipted bill and letter from the attending physician to the insurance carrier, stating that the purchase was necessary and in accordance with the physician’s direction. As of July 11, 2007, the law specifically authorizes pharmacies to direct bill the insurance carrier and requires the insurance carrier to pay for the prescription or reimburse the employee within 45 days of receipt of the claim for payment or reimbursement. It also allows the insurance carrier to contract with a pharmacy or pharmacies and require claimants to use the pharmacy or pharmacies to obtain their prescriptions. The only exceptions are when a medical emergency occurs and it is not reasonably possible to obtain immediately required prescribed medicines from such pharmacy or pharmacies or the pharmacy or pharmacies do not offer mail order service and do not have a physical location within a reasonable distance from the claimant.
Related Questions
- If a recipient is covered by a state or local "English-only" law, must it still comply with the Title VI obligation and agency guidance interpreting that obligation?
- When will the new law begin providing Medicare coverage for prescription drugs?
- Are prescription drugs and medications covered under the law?
