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Refused at the Pharmacy Counter: How to Improve Medicare Part D Appeals

Winter, 2013

Each year, the Medicare Rights Center (Medicare Rights) receives up to 5,000 calls from people with Medicare, family caregivers and service providers seeking help with Medicare appeals and coverage-related issues. Many of these calls are from beneficiaries or caregivers recently refused a prescription at the pharmacy counter. Often, people refused access to a drug are not told the reason their prescriptions are not being filled. Pharmacists tend to have no or, at best, incomplete information and can only direct the person to call their drug plan for the denial reason…