10 Reasons Why You May Be Paying Full Price For Your Medications - 6. Quantity Limit Exceeded

Your Medicare plan coverage · published Feb 27, 2009

(6) Quantity Limit Exceeded - You have exceeded your monthly quantity limit for a particular medication. If you are using a medication that has a 30/30 quantity limit (30 tablets for 30 days) and have already filled one prescription for the first 30 tablets and now are seeking a refill of an additional 30 tablets before the end of the 30 days, you may find that your Part D plan will not cover the medication. If you need to extend your coverage beyond the quantity limit, have your physician ask for an exception, providing a reason for the additional tablets. If you wish to see if one of your medications is subject to utilization management requirements, you can select your state, medication and Part D plan from our PDP-DrugFinder. For instance, here is an example of utilization management requirements for Lipitor 10MG under AdvantraRx Part D plans in Florida (30 tablets for a 30 day period).

Also See:
1. Member ID Card Problems
2. Still in Initial Deductible
3. Non-Covered Prescription
4. Retail Price Less than Co-Payment
5. In the Donut Hole
7. No Prior Authorization
8. Referenced-Based Pricing
9. Out of Network Purchase
10. No Prescription is on File