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New Resource Explains What Seniors Can Do if Medicare Denies Coverage of Their Medicines

Friday, October 12, 2007 General News
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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.
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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.
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"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:



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.

-- 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.

SOURCE National Pharmaceutical Council
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