I went to pick up my medications at the pharmacy the other day, but I couldn’t afford the expensive copayments. I was told I have Extra Help, but my pharmacist is telling me I owe a lot of money for my medications. What can I do to get my drugs?
August 1, 2012
Dear Marci, I went to pick up my medications at the pharmacy the other day, but I couldn’t afford the expensive copayments. I was told I have Extra Help, but my pharmacist is telling me I owe a lot of money for my medications. What can I do to get my drugs? —Rob
Dear Rob,
If you have Extra Help and a Part D plan, you can present Best Available Evidence (BAE) to your pharmacist to get your medications at the copayments offered under Extra Help. Your Extra Help status may be incorrectly reflected in either your plan or pharmacy’s system. If you show your pharmacist your Medicaid card, Social Security Administration award letter indicating your Extra Help status, or Medicare Savings Program Notice of Award letter, the pharmacy should only charge you the Extra Help copayments for your medications. Your plan should update your Extra Help status in its system within 48 to 72 hours so you can access your medications with Extra Help copayments the next time you fill a prescription. If you cannot find proof that you have Extra Help, your plan must work with Medicare to investigate whether you have the Extra Help benefit.
—Marci
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