Because Medicare Part D plans can make changes to their lists of covered drugs during the course of a year.
While 7 out of 10 Medicare Part D patients currently have coverage for Toujeo or Lantus, it's important to check that your plan will continue to cover your Toujeo or Lantus prescription, and any other prescription medications you may take, in 2021.
Use the Medicare Part D Plan Finder to check if you are eligible to change your plan to one that covers your prescription medicines. If you can't change plans, and your doctor agrees you should stay on your treatment plan, you can request a coverage exception form from your plan provider. Either way don't worry, your pharmacy will provide you with a transition refill.
A transition refill is a one-time, 30-day-supply refill of your prescription medication at your same copay.
Your Medicare Part D plan provider should send you a letter with additional actions you can take. If you don't receive a letter, you can contact your Medicare Part D plan provider via their website or phone number found on the back of your Medicare Part D prescription card.
A coverage exception form allows you to formally ask your plan provider to cover your prescription medicine. This allows you to stay on the Lantus, Toujeo, or other medicines prescribed by your doctor.
The Coverage Exception form can be provided by your Medicare Part D plan provider's website or customer service line. This information can be found on your Medicare Part D card.
Take the form to your doctor and they can help you complete any remaining portions of the form so you can submit it to your plan provider.
It's important to understand that under certain circumstances, drugs may be removed from a Medicare Part D Drug plan during the year. If you have additional questions about your coverage, you can call your Medicare Part D insurance provider to help you navigate your way through this process by using the phone number that can be found on the back of your prescription card.
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MAT-US-2000513 Last Updated: April 2020