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Table of Contents
Getting Started - The Basics
About Enrolling
Costs and Coverage
Problems Getting Your Drugs Under Your Plan
Other Common Problems / Changing Plans
Health Care Reform and Part D
Information for Medicare Providers
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What if my doctor prescribed a dosage that is not covered by my Part D plan?
First, contact your doctor.
Explain to your doctor that your Part D plan refused to cover your drug
because the prescribed dosage is not on the plan's formulary. Find out whether
your doctor will prescribe a substitute drug or a different dosage that
is on your Part D plan's formulary.
If your doctor believes that you must have the prescribed dosage, then ask
your doctor to contact your Part D plan to request an "Exception"
and to explain why the dosage is medically necessary.
NOTE:
You have a RIGHT to request an Exception.
For questions or advice, contact
Legal Services for the Elderly at 1-800-750-5353.
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Get more information about requesting an
Exception.
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