If you are living in a long-term care (LTC) facility, you are also granted a one month's supply for your Part D drugs, but your Medicare plan may provide an additional 31-day Emergency Fill after the 90-day period - depending on your circumstances. You can read more in our FAQ about transition fills in a LTC facility.
And as reference, please see:
CMS Medicare Prescription Drug Benefit Manual, Chapter 6 – Part D Drugs and Formulary Requirements, Section 30.4 - Transition (Rev. 18, Issued: 01-15-16, Effective: 01-15-16; Implementation: 01-15-16)
30.4.4 - Transition Timeframes and Transition Supply
Within the first 90 days of coverage under a new plan, plans must provide a transition supply when the beneficiary requests a non-formulary drug. This 90 day timeframe applies to retail, home infusion, long-term care, and mail-order pharmacies. CMS believes it makes sense to both limit and define the amount of time during which a transition process is applicable. Thus, plans are required to provide a temporary fill anytime during the first 90 days of a beneficiary’s enrollment in a plan. However, since certain enrollees may join a plan at any time during the year, this requirement applies beginning on such an enrollee’s first effective date of coverage instead of to the first 90 days of the plan year. If an enrollee leaves a plan and re-enrolls during the original 90 day transition period, the transition period begins again with the new effective date of enrollment, because it is possible that the enrollee’s drug therapy changed while the enrollee was not with the plan and that therapy could be potentially interrupted. However, if there is no gap in coverage, there is no new transition period.Section 30.4.4.1 - Timeframe and Transition Supply in the Retail Setting
"In the retail setting, the transition fill of non-formulary Part D drugs must be for at least [one month] days, unless the prescription is written by a prescriber for less than 30 days. Part D sponsors must allow multiple fills to provide at least [one month] of medication in accordance with 42 CFR §423.120(b)(3)(iii)(A). If the smallest available marketed package size exceeds a [one month's] supply, the sponsor must still provide a transition supply when required. Part D sponsors and their processors must determine how to process claims in such cases."Please note: In 2018, the Centers for Medicare and Medicaid Services updated federal regulations (42 CFR §423.120) changing the 2019 LTC transitions supply to a one month's supply coinciding with a Medicare Part D out-patient beneficiary's supply and changed the "30-day" transition supply to a one month's supply, noting:
"To reduce waste, [starting in 2019] we are conforming the transition supply provided in the long term care setting (currently 90 days) to the transition supply provided in the outpatient setting (currently 30 days) so that the transition supply in both settings is for the same period. We are also changing the “30-day transition supply” to “an approved month’s supply” so that it will now be equivalent to the approved month’s supply for the applicable plan bid. Thus, Part D sponsors will be required to provide an approved month’s supply in both the long term care [LTC] and outpatient settings."See:
"CMS Finalizes Policy Changes and Updates for Medicare Advantage and the Prescription Drug Benefit Program for Contract Year 2019 (CMS-4182-F)" (https://www.cms.gov/newsroom/fact-sheets/cms-finalizes-policy-changes-and-updates-medicare-advantage-and-prescription-drug-benefit-program)
"Changes to the Days' Supply Required by the Part D Transition Process (§ 423.120)" https://www.federalregister.gov/documents/2018/04/16/2018-07179/medicare-program-contract-year-2019-policy-and-technical-changes-to-the-medicare-advantage-medicare