Part D AARP Rx drug plan just discontinued covering my sister's pain med which is critical in keeping her out of pain. No notification but found out when she tried to refill it. Cost is $800-$1800 which they cannot pay. She has been working with a pain management dr. for over a year who closely monitors her. This is the only drug that covers her pain. Can the pain management dr. provide something to get them to cover it? Going to see if another plan will cover it but wondering if anything can be done with the current drug company.
https://dailycaring.com/5-steps-to-take-when-medications-are-not-covered-by-medicare/
Here is another link that was embedded in the above article.
Seniors can get help paying for prescription drugs
https://dailycaring.com/seniors-can-get-help-paying-for-prescription-drugs/
Lastly, maybe look at GoodRX.
https://www.goodrx.com/medicare?utm_campaign=11601593411&utm_content=114733543362&utm_source=google&utm_medium=cpc&utm_term=kwd-364991598140&gclid=Cj0KCQjwr4eYBhDrARIsANPywCjYKT7CRj9gePAMyahyMThEenkxaxMoILhPs6wksD69-hQ-T60B62caAnw3EALw_wcB&gclsrc=aw.ds
My nephew is on Medicaid. He too had a Med that the prescription company Medicaid used said was not covered anymore. This is the only med that worked for him. In talking to Office of Aging we were told that medication is on a tier. The tier he was receiving no longer allowed that med. At the time to go up a tier it was an extra $5 a month. He eventually weened off the meds but by the time he did, it was $16 a month xtra for that tier.
Ask the company if they dropped the med altogether or are there tiers. The xtra cost to go up a tier would still be cheaper than the cost of the med.
The only plans I know who handle Medicare and prescriptions is a Medicare Advantage plan.
The dr will have to appeal this. It may take some time, but you can be sister's advocate and help her out.
Good Luck. Chronic pain can just wear you out.
"Physicians and staff may not accept pharmaceutical samples for their own personal use or for distribution to patients or family members. Distributing sample drugs would place physicians in a drug dispensing role, subject to applicable laws and regulations.”"