FAQs on Transition Fills

FAQs on Transition Fills

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•	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 . . .
•	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 . . .

•	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&# . . .