Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account

New Posts   Today's Posts

Medicare Part D quantity limits
Why do Part D Rx med formularies have quantity limits on some meds?
Is this just some game the insurance companies play to maximinze profit?

Or, it it actually in the Medicare rules?

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
Post Reply Post Reply

Donate to Apnea Board  
You can get exceptions. Contact your supplemental policy and ask them how to get an exception. I have a quantity limit on one of my prescriptions, but the doc applied for an exception before I even got home since he knew this limit was common. They had my prescription ready for me by 6 p.m. It is extremely uncommon for someone to take this med twice a day.

Why do they have these limits? I think it's just on these expensive medications. I can also only get auto refills every 30 days - can't fill it for 90 days even though I know I will be on it for 6 months. They WANT you to use the most common form of your med, which is usually the cheapest. When you go outside of the norm, they want justification for it. I am assuming this is the thought process. That was the case with a non-formulary drug last year.
Post Reply Post Reply

Possibly Related Threads...
Thread Author Replies Views Last Post
  Medicare Advantage Provider Adding Elevated Diagnosis Codes When Billing Medicare Crimson Nape 12 1,024 10-17-2017, 10:08 AM
Last Post: AlanE
  US Medicare numbers to change from the SSN. justMongo 9 746 04-03-2017, 02:52 PM
Last Post: AlanE
Information [News] Medicare unveils far-reaching overhaul of doctors' pay ApneaNews 0 576 10-14-2016, 05:27 PM
Last Post: ApneaNews
  Diabetes Testing under US Medicare justMongo 21 1,913 07-18-2016, 05:33 PM
Last Post: 0rangebear
  US Medicare Medigap Question justMongo 5 888 11-14-2015, 02:49 PM
Last Post: eplantz
  Medicare and B12 me50 12 2,430 07-09-2015, 09:50 AM
Last Post: Mosquitobait
  How do you sue Medicare -- I mean take 'em to the woodshed. justMongo 9 2,294 02-04-2015, 11:55 AM
Last Post: archangle

Forum Jump:

New Posts   Today's Posts

About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.