What is a Medicare Part D Exception?
In a Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan, an exception is a type of prescription drug coverage determinationA coverage determination is the first decision made by a Medicare Part D plan (not the pharmacy) about a plan member's drug benefits..
You must request an exception, and your doctor or another prescriber must send a supporting statement explaining the medical reason for the exception.