What if the prescription drug an individual takes is not covered by the Medicare drug plan? Will Medicaid still pay for it?
If Medicare covers a prescription drug, Medicaid will not pay for it. However, Medicare drug plans don’t have to cover every drug that’s included in Medicare prescription drug coverage. They only have to cover every type of drug. Individuals should review what drugs are covered by the Medicare drug plans available in their area and try to join one that covers the same prescriptions they take now. If the Medicare plan doesn’t cover the exact prescriptions, it’s required to have a transition period where current drugs may be covered for a certain length of time while individual’s work with their doctor to find an alternative prescription drug to take that is covered by the plan. If the doctor believes an individual should not switch to a covered prescription drug, the individual or doctor can contact the Medicare plan and ask it to give an “exception”, which means the plan agrees to pay for the current drug. If the plan refuses to give an exception, an individual can appeal the plan’s de
Related Questions
- What if I am enrolled in a Medicare Part D Plan and I want to use my OPDP discount card on a drug not covered by my Medicare Plan drug list?
- What if the prescription drug an individual takes is not covered by the Medicare drug plan? Will Medicaid still pay for it?
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