Medicare Part D – Prescription Drug Coverage

This ACP website will assist you in helping your patients by providing you and your staff with basic, practical information on the Part D benefit and linking you to patient-oriented materials that you can use in your offices.

Latest Site Additions

Part D Plan Details for 2009

Information on 2009 Medicare Part D E-prescribing Incentive

New Web-based Option to Verify Coverage and Bill Herpes-Zoster Vaccine

CMS releases an instructional guide on reimbursement for vaccine and vaccine administration under Medicare Part D

See Latest CMS Releases and Announcements on the Part D Benefit below

 

Medicare Prescription Drug Coverage and You (Updated 2009)

This ACP developed patient brochure that can be downloaded for use in your office explains the Part D benefit and provides resources for further information and help.

Medicare Part D Short Course 2009[PDF]

This brief article lists the 10 things every practitioner should know about the new Medicare Part D Drug benefit.

Medicare Part D Resource List

This link contains a number of practical Part D resources for physicians.

Other Selected Patient Fact Sheets and Brochures:

Latest CMS Releases and Announcements on the Part D Benefit


Exceptions and Appeals Process under Medicare Part D Drug Benefit

All Part D plans are required to have an exceptions and appeals process that provides enrollees with the opportunity to challenge the exclusion of a particular drug from a plan's formulary or the placement of a drug on a higher cost-sharing tier. This ACP article reviews the basic requirements for exceptions and appeal procedures instituted by the different drug plans.

Standardized Medicare Part D Coverage Determination Request Form

The form can be used to request approval for a drug not in a plan’s formulary, for an exception to a formulary tier, and for providing data to meet prior authorization requirements.

Demystifying Medicare Part D's Exception and Appeal Process

An updated article from the April 2006 ACP Observer answers frequently asked questions on the Part D exceptions and appeals process.

Required Transition Processes for Medicare Part D Plans

Other Useful Educational Links

  • Consumer Reports Best Buy Drugs—The information on this website can help patients learn about affordable drug treatment options to discuss with their physicians. More specifically, the site provides an expert medical review of those drugs commonly used to treat a variety of specific conditions or illness combined with the price of the drugs. The reports, which can be downloaded, also provide recommendations regarding the most cost effective treatments under different situations. The information on the Consumer Reports Best Buy Drugs link has been compiled as a free public educational service by the nonprofit Consumers Union.

  • My Medicare Matters is a site sponsored by the National Council of Aging and the Access Benefit Coalition that provides useful information regarding the Part D Drug benefit delivered in three separate portals; one for beneficiaries, one for family and friends, and one for health care professionals.


Can't find what you need or do you want to report a problem you are having with a drug plan? Contact the PMC.

 

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Page updated: 6-19-06

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