FAQs on Transition Fills

FAQs on Transition Fills

Browse the Most Viewed and Newest Medicare Part D FAQs
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Category: Transition Fills

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Most Viewed FAQs in Category

When can I get a transition fill or temporary supply of my Medicare Part D prescription drugs?
You can get a 30-day temporary or transition prescription drug fill if you: stayed with the same Medicare Part D prescription drug plan (or Medicare Advantage plan that includes drug coverage) . . .
Can I ask for a formulary exception before the start of the new coverage period that starts in January?
Yes. Medicare anticipates that Medicare Part D and Medicare Advantage plans will allow new plan members to file requests for formulary exceptions or coverage determinations before the beginning . . .
Is it possible to get an extension for my transition fill?
Yes - but only in specific circumstances. Your Medicare Part D plan may provide you with a transition fill extension. However, such an extension is provided only on a case-by-case basis in exception . . .
What is a transition fill?
A transition fill is a temporary 30-day prescription supply of a non-formulary drug provided to: People who have stayed with the same Medicare drug plan into the next year and now find that th . . .
How long will I have to fill my transition fill?
Usually 90 days. Your 30-day supply transition fill is usually only valid for the first 90 days of your Medicare drug plan enrollment.If you are living in a long-term care (LTC) facility, then you . . .
What is considered a non-formulary Medicare Part D drug for purposes of a transition fill?
As noted by the Centers for Medicare and Medicaid Services (CMS), for the purposes of the transition fill policy, non-formulary Medicare Part D drugs are: (1) Part D drugs that are not on a [Medic . . .
Are the rules for transition fills or a temporary drug supply different for people who reside in a long-term care (LTC) facility?
Yes. If you reside in a long-term care facility, and find that one of your of prescription medications is no longer covered by your current Medicare Part D plan (or Medicare Advantage plan that . . .
How much will I pay for the transition fill of a non-formulary drug?
If you are granted a transition fill, your Medicare Part D plan will charge you the same cost-sharing amount as you would pay if a formulary exception request has been granted and your non-formulary . . .
Who can get a transition fill?
A transition fill or temporary drug supply is available to:People who did not change their Medicare plan coverage from the previous year and now find that their medications are not covered due to . . .
Can I get a transition fill for one of my prescriptions not covered by the Medicare Part D program?
No - unless the non-Part D drug is used for a medically-accepted indication. Specific prescription medications are excluded from the Medicare Part D program or sometimes medications are removed . . .

Newest FAQs in Category

What is considered a non-formulary Medicare Part D drug for purposes of a transition fill?
As noted by the Centers for Medicare and Medicaid Services (CMS), for the purposes of the transition fill policy, non-formulary Medicare Part D drugs are: (1) Part D drugs that are not on a [Medic . . .
Where can I learn more about how much I will pay for a transition fill?
Your Medicare Part D plan's Evidence of Coverage document will provide you with information about what you will pay for a transition fill of a non-fomrulary drug. You Evidence of Coverage is a . . .
Can I get a transition fill for one of my prescriptions not covered by the Medicare Part D program?
No - unless the non-Part D drug is used for a medically-accepted indication. Specific prescription medications are excluded from the Medicare Part D program or sometimes medications are removed . . .
Can I ask for a formulary exception before the start of the new coverage period that starts in January?
Yes. Medicare anticipates that Medicare Part D and Medicare Advantage plans will allow new plan members to file requests for formulary exceptions or coverage determinations before the beginning . . .
Is it possible to get an extension for my transition fill?
Yes - but only in specific circumstances. Your Medicare Part D plan may provide you with a transition fill extension. However, such an extension is provided only on a case-by-case basis in exception . . .
How much will I pay for the transition fill of a non-formulary drug?
If you are granted a transition fill, your Medicare Part D plan will charge you the same cost-sharing amount as you would pay if a formulary exception request has been granted and your non-formulary . . .
Are the rules for transition fills or a temporary drug supply different for people who reside in a long-term care (LTC) facility?
Yes. If you reside in a long-term care facility, and find that one of your of prescription medications is no longer covered by your current Medicare Part D plan (or Medicare Advantage plan that . . .
What is a transition fill?
A transition fill is a temporary 30-day prescription supply of a non-formulary drug provided to: People who have stayed with the same Medicare drug plan into the next year and now find that th . . .
Who can get a transition fill?
A transition fill or temporary drug supply is available to:People who did not change their Medicare plan coverage from the previous year and now find that their medications are not covered due to . . .
If my medications are now subject to drug restrictions (prior authorization) is it possible to get a transition fill while requesting a formulary exception?
Yes. According to the Centers for Medicare and Medicaid Services (CMS), the transition fill policy will apply to both non-formulary Part D drugs and “Part D drugs that are on a sponsor&# . . .