Knowing why a prescription drug is denied at the pharmacy counter is critical to helping beneficiaries determine their next steps—whether it is working with their physician to secure an alternative or appealing for coverage from their Part D plan. All Part D plans should be required to provide an individually tailored denial notice at the pharmacy counter, explaining why the prescription cannot be filled. Further, this notice should count as a coverage determination—eliminating a needless step in the appeals process for Medicare beneficiaries.