If you have a Medicare drug plan or Medicare Advantage Plan with drug coverage

You have the same rights and protections as all people with Medicare. You also have the right to:

• Get a written explanation for drug coverage decisions (called a “coverage determination”) from your Medicare drug plan.
  • A coverage determination is the first decision your Medicare drug plan (not the pharmacy) makes about your benefits. This can be a decision about if your drug is covered, if you met the plan’s requirements to cover the drug, or how much you pay for the drug.
  • You’ll also get a coverage determination decision if you ask your plan to make an exception to its rules to cover your drug.
• File a complaint (called a “grievance”) with the plan. A grievance is a complaint about the way your Medicare health or drug plan is giving care.
• Have the privacy of your Medicare health and drug information protected.

If you have Medicare drug coverage, your plan will send you information that explains your rights. Call your plan if you have questions.