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New
resource explains what Seniors can do if
Medicare denies coverage of their
medicines...
Brochure outlines
step-by-step process and provides sample
appeal letter
WASHINGTON, Oct. 11 /PRNewswire-USNewswire/
-- Medicare prescription drug coverage has
given many seniors peace of mind that they
will have access to the medicines they need.
But occasionally, because of individual plan
rules, the medicine that's prescribed by the
doctor isn't always covered. Seniors who
encounter this situation have options, but
they need to know what they can do about it.
To equip seniors with the
knowledge they need to get the most from
their plans, a new brochure available
through Your Pharmacy Benefit (YPB), a
collaborative consumer education effort,
outlines the specific steps people can take
to get their medicines covered.
"With a little
persistence, Medicare beneficiaries can
often get
coverage for the medicines
they need to stay healthy, while controlling
their costs," said Rick Kellerman, M.D.,
president of the American Academy of Family
Physicians, one of the organizations
involved in YPB. "People need to understand
their rights -- and what they can do to help
secure coverage."
Patients have the right to
request coverage for their medicines and to
appeal Medicare's decision if that coverage
is denied, but they must follow a specific
process. The brochure helps people decide
whether they should start this process,
explains how it works and includes
definitions of key terms. It also provides
hands-on tools such as a sample appeal
letter, a step-by-step table of the coverage
request process and additional resources
such as links to
Medicare's appeal forms.
Titled "Using Your
Medicare Drug Plan: What to Do if Your
Medicine Isn't Covered," the brochure is
available in English and Spanish through the
Federal Citizen Information Center. People
can request copies of the brochure by:
-- Sending their name
and address to Publication Number 661P,
Pueblo, CO 81009.
-- Calling toll-free
1-888-8-PUEBLO (1-888-878-3256), weekdays 8
a.m. to 8 p.m. EST.
-- Visiting
http://www.pueblo.gsa.gov to
place an order online or to read and print
these and hundreds of other Federal
publications for free.
Other resources provided
by Your Pharmacy Benefit focus on choosing,
understanding and using prescription
coverage. By acting as a one-stop-shop for
clear, concise and helpful information on
how to get the most out of prescription drug
coverage, Your Pharmacy Benefit ensures that
consumers -
both with private
insurance and Medicare Part D -- have the
information they need to make the best
decisions about their coverage needs.
Your Pharmacy Benefit's
Web site and free brochures provide a
step-by-step guide for selecting the right
prescription plan, information about how
pharmacy benefits are typically structured
and glossary terms that help consumers
translate "insurance-speak." In addition,
the site and brochures contain suggestions
on how to use prescription benefits to their
full potential, hints on how to save money
and tips on what to do when your
prescription is denied for payment.
For more information,
visit
http://www.YourPharmacyBenefit.org.
About Your
Pharmacy Benefit:
Your Pharmacy Benefit is
an in-depth resource designed to help
consumers and those who
care for them understand the value of and
make better use of their prescription
coverage - whether they are covered through
private insurance or Medicare Part D. YPB is
a collaborative effort between a growing
number of diverse organizations dedicated to
helping consumers choose and effectively use
their prescription drug coverage. For a full
list of YPB partners, visit
http://www.yourpharmacybenefit.org/private/about.asp.
SOURCE National Pharmaceutical Council
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