The Exceptions and Appeals Process: Issues and Concerns in Obtaining Coverage Under the Medicare Part D Prescription Drug Benefit

Publication Date: November 2005

Publisher: Henry J. Kaiser Family Foundation

Author(s):

Research Area: Health

Type: Brief

Coverage: United States

Abstract:

This issue brief describes how Medicare beneficiaries navigate the Medicare Part D exceptions, appeals, and grievances processes to get access to medically necessary prescriptions not covered under their Medicare prescription drug plans. It identifies and describes policy issues that may make it difficult for beneficiaries to utilize the processes.