You and/or your prescriber must contact the drug plan before you can fill certain prescriptions.
What is Prior Authorization?
100
This is when Medicare Part A will pay for your prescription drugs.
What is drugs you need during a Medicare-covered stay in a hospital or skilled nursing facility.
100
This is what you can ask for if your prescriber thinks you need a drug that's on a higher tier, to get a lower copayment.
What is exception?
100
This is the region number of Pennsylvania under Silverscript.
What is 06?
100
According to Medicare, all plans must cover at least this many drugs from each class.
What is 2?
200
This is how the drugs are covered under the Silver Script Choice to treat anorexia. (Prozac)
What is not covered?
200
This is how my Part B drugs are affected when I enroll into a stand-alone PDP plan.
What is they will not be affected or changed based on your enrollment into a stand alone PDP Plan?
200
The number of days supply you can receive if your prescription drug is removed from the formulary and you did not receive written notice of the drug being removed. This prescription would be under the same plan rules.
What is 60 days?
200
In order to be eligible for Medication Management program, you must have this many or more of the listed long-term health conditions.
What is 3?
200
This is the type of coverage when plans cover some of excluded drugs. They would probably charge a higher premium for this additional benefit.
What is enhanced alternative coverage?
300
If this appears it means that depending on the circumstances a prescription may be billed under Part B or Part D.
What is B vs D?
300
The condition you must have in order for Medicare to pay for clotting factors you give yourself by injection.
What is hemophilia?
300
According to Medicare rules, this is the amount of weeks you should receive your Welcome kit and ID cards in.
What is 5 weeks?
300
Silver Script Plus is not available in this state.
What is Alaska?
300
This is the average nation wide Part D premium in 2017.
What is $35.63?
400
In order for a script of Firazyr (Anti-Inflammatory) to be covered, one of these two types of doctors must be the prescriber. Under the Keystone 65 Plans.
What is allergist or immunologist?
400
Under original Medicare, these are the three vaccines that are covered as preventive under Medicare Part B without out of pocket costs.
What is influenza, pneumonia, and Hepatitis B?
400
In 2018, this is the highest a Rx Plan can have as their deductible.
What is $405?
400
These are the four ways you can enroll into the Basic Blue RX.
What is Medicare website, Basic Blue website, inbound telephonic enrollment, and paper application?
400
What are the three vitamins that will be covered under Part D plans in certain situations and/or conditions.
What is Niacin ▪ Prenatal vitamins ▪ Fluoride?
500
Under CVS Carkmark, this is the supply amount patients new to opioids will receive of the medication. (Measured in days)
What is 7 days?
500
This is the Healthcare Common Procedure Coding System modifier used on a Medicare Part B drug claim to report the amount of drug or biological that is discarded and eligible for payment under the discarded drug policy.
What is the JW modifier?
500
In general, Medicare’s contractor makes reconsideration decisions within this amount of days.
What is 90 days?
500
During the dis-enrollment period, these are the two ways a member can dis-enroll from the Basic Blue RX.
What is sending a written request or by calling Medicare?
500
The act that requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage.