Medicare Advantage Question of the Day: Temporary Drug Supplies

  • Originally published December 28, 2011 , last updated January 12, 2016
  • Medicare
Medicare Advantage Question of the Day: Temporary Drug Supplies

Our Medicare Advantage experts help you stay compliant with real-life scenarios encountered by agents in the field.

Question:

How should an agent answer the following question from a client considering purchasing Part D? “If I join your plan and a medicine that I use is not on your formulary, would I be able to get a temporary supply of my medicine?”

Answer:

“If you are currently taking a drug that is not on our formulary or is subject to additional requirements or limits, you may be able to get a temporary supply of the drug. While you talk to your doctor to determine the right course of action, we may cover your drug in certain cases during the first 90 days you are a member.”

This was an actual question posed by a secret shopper to one of our agents during AEP. Did you know the answer?