What if I bring a prescription for a cancer drug into the pharmacy that is supposed to be covered under Part B? Can the pharmacy or the drug plan deny coverage under Part D?
Generally speaking, the answer is no. Pharmacies and drug plans are not supposed to deny coverage for a cancer drug if you bring a prescription into a pharmacy and the drug might be covered under Part B instead of Part D. But, cancer drugs clearly covered under Part B might not be on a plan’s formulary, and your pharmacy or drug plan may deny coverage for these drugs. Also, in some cases a drug plan may require prior authorization for certain drugs to be sure that your diagnosis or use of the drug is in line with Part D coverage. If this happens to you, contact your plan or Medicare (call 1-800-633-4227 or visit www.medicare.gov). to find out how to resolve the problem.
Related Questions
- What if I bring a prescription for a cancer drug into the pharmacy that is supposed to be covered under Part B? Can the pharmacy or the drug plan deny coverage under Part D?
- When must a Part D drug plan fill a prescription at an out-of-network pharmacy?
- What prescription medications are covered under the USA Drug Plan?
