If your drug is not on the Drug List (Formulary) or is restricted, you may be able to get a temporary supply of the drug (only members in certain situations can get a temporary supply). Under certain circumstances, the plan can offer a temporary supply of a drug to you when your drug is not on the Drug List or when it is restricted in some way. Doing this gives you time to talk with your doctor about the change in coverage.
To be eligible for a temporary supply, you must meet the two requirements below:
If you are a current member affected by level of care changes, we will provide a temporary supply of the non-formulary drug during the first 90 days after your level of care changes or provide you with the opportunity to request a formulary exception in advance for the following year. Please note that our transition policy applies only to those drugs that are “Part D drugs” and bought at a network pharmacy. The transition policy can’t be used to buy a non-Part D drug or a drug out of network, unless you qualify for out of network access.
To ask for a temporary supply, call Customer Services at 1-800-681-9585 (TTY users should call the State Relay Service number at 711) available 24 hours a day, 7 days a week.
During the time when you are getting a temporary supply of a drug, you should talk with your doctor to decide what to do when your temporary supply runs out. Perhaps you can change to an alternative drug covered by Senior Care Plus formulary or you and your doctor can ask for a formulary exception. If you have any questions for Senior Care Plus regarding Part D transition policy, please contact Customer Services using the contact information below.
(Información en español)
Toll free: 800-336-0123
TTY Relay Service 711
Senior Care Plus
A Medicare Advantage organization from Hometown Health
Material ID: H2960_2021_SCPWebsite1_M (CMS Accepted)