Patients may require coverage review to receive prescription drug coverage

With the recent move to a group-sponsored Medicare prescription drug plan administered by Express Scripts, UAW Retiree Medical Benefits Trust members may require a coverage review in order to ensure continued access to medications in the 2013 plan year.

The Medicare Part D program requires plans to determine the appropriate payer for medications that may be considered Part D or Part B based on medical diagnosis and place of treatment prior to allowing coverage of the medication. Some of your patients might be taking a medication that’s classified as such.

Express Scripts has mailed and faxed letters to physician offices requesting the required information on behalf of the Trust’s impacted patients. Express Scripts also mailed letters to impacted patients in December to alert them of this requirement.

If your office has received one of these letters or a phone call from a patient regarding this process, please call the Express Scripts Coverage Review Department at 1-800-935-6103, available 24 hours a day, seven days a week. They will help provide you with the information required to begin the coverage determination process. This will help ensure that your patient has uninterrupted access to his or her medication in 2013.