insurance

Fighting a Drug Coverage Denial

These workarounds should help curb the Rx stalemate.

Question: My Medicare Part D plan is not covering a drug that my doctor prescribed. What can I do? - D.W., Dallas

Answer: Find out why the drug wasn’t covered. Your doctor may just need to fill out a prior authorization form each year explaining why you need the drug. If insurance still doesn’t cover it, ask your pharmacist for the cash price, which may be less with coupons or discount programs found through GoodRx.

Alternatively, ask your doctor if you can switch to another drug that is covered by your insurance. Many plans have online tools listing these “therapeutic alternatives” and showing how much you’d pay.

If that doesn’t work, your doctor can request an exception or file an appeal (see medicare.gov/appeals). Your pharmacist and State Health Insurance Assistance Program can help (see shiptacenter.org).

Most Popular

Your Guide to Roth Conversions
Special Report
Tax Breaks

Your Guide to Roth Conversions

A Kiplinger Special Report
February 25, 2021
Can't Sleep at Night? Consider Getting Checked Out By a Doctor
health insurance

Can't Sleep at Night? Consider Getting Checked Out By a Doctor

Older adults are more likely to suffer from sleep disorders, such as insomnia and sleep apnea. Left untreated these conditions can have dire consequen…
May 26, 2021
Midyear Investing Outlook: Where to Invest Now
Kiplinger's Investing Outlook

Midyear Investing Outlook: Where to Invest Now

After a powerful start, stocks will grind higher in the second half of 2021. But watch out for curveballs.
May 23, 2021

Recommended

Can't Sleep at Night? Consider Getting Checked Out By a Doctor
health insurance

Can't Sleep at Night? Consider Getting Checked Out By a Doctor

Older adults are more likely to suffer from sleep disorders, such as insomnia and sleep apnea. Left untreated these conditions can have dire consequen…
May 26, 2021
Do You Need Life Insurance When You're Young?
Financial Planning

Do You Need Life Insurance When You're Young?

As millennials have families and take on financial obligations, we need life insurance to protect those we may leave behind.
May 24, 2021
You Can Keep Some Assets While Qualifying for Medicaid. Here's How
Long-Term Care Insurance

You Can Keep Some Assets While Qualifying for Medicaid. Here's How

There are some tools you can use to avoid spending down all of your assets, and potentially impoverishing a spouse, while still meeting the qualificat…
May 24, 2021
High-Deductible Health Plans: Don’t Let the Name Scare You Off
health insurance

High-Deductible Health Plans: Don’t Let the Name Scare You Off

Some people are biased against high-deductible health insurance plans — just because of the name. It’s unfortunate, because for most people an HDHP ca…
May 21, 2021