10 Reasons Why You May Be Paying Full Price For Your Medications - 7. No Prior Authorization

(7) No Prior Authorization - You are purchasing the medications without prior authorization from your Medicare Part D plan. Some medications are carefully monitored by Medicare Part D plans and require that the Medicare beneficiary receives prior authorization from the Part D plan before the prescription will be covered by that plan. If you are not sure about which of your medications require a prior authorization, you can use our PDP-DrugFinder tool to check your prescriptions. In the PDP-DrugFinder, you can enter your medication, choose the strength if there are multiple varieties and choose your Medicare Part D plan (or two plans if you wish to compare) and we show an indication of “P” for medications that require a prior authorization. Prior Authorization forms can be ordered from your Part D plan or downloaded from a Part D plan’s website and your physician can usually complete them and fax the forms directly to the Part D plan. Please note that we have recently been advised that some Part D plans are requiring a prior authorization form be filed for each prescription re-fill.

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
6. Quantity Limit Exceeded
8. Referenced-Based Pricing
9. Out of Network Purchase
10. No Prescription is on File