(10) No Prescription is on File - Strange but True - You do not have a prescription for the medication on file with the pharmacy – this is an unusual situation, but possible. We have been working with a Medicare beneficiary who purchased her insulin (Humalin) throughout all of 2006, 2007, and 2008 without having a prescription and paid full price for the medication, even though it should have been covered by her Part D prescription drug plan. Her pharmacist, physician, and Part D plan did not notice the missing prescription, even when her physician advised her to increase her dosage of insulin. Once the error was found, the physician issued the prescription and the Part D plan offered to reimburse back cost and recalculate coverage gap timing - but only when the Beneficiary could produce the receipts for the prescription purchases because they were not recorded by the pharmacy since they were purchased outside of her Part D plan and treated as a normal over-the-counter purchase.
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