Disaster Recovery: Medicare Part D Medication Replacement

Q: Will beneficiaries be able to obtain early refills on their Part D medications that were lost or misplaced during a declared emergency?

A: We expect that Part D plans would guarantee immediate refills of Part D medications to any beneficiary located in an "emergency area" defined as the area in which there has been a Stafford Act or National Emergencies Act declaration and a public health emergency declaration. In addition, we would expect all "refill too soon edicts" to be removed beginning with any voluntary or mandatory state or federal evacuations and lasting for the period of the emergency declaration. Additionally, with the possibility of only a limited number of operational pharmacies, limitations on transportation and travel and the disruption of US Mail, we expect plans to allow the beneficiary to obtain the maximum plan extended day supply, if requested and available at time of refill.

-- Wayne R. Lindley, California SHIP-HICAP Director

Q: What happens during a public health emergency, when beneficiaries need to use a network pharmacy for urgent access to necessary medications?

A: During any state or federal disaster declaration, or other public health emergency declaration in which beneficiaries are evacuated or otherwise displaced from their place of residence and cannot be reasonably be expected to obtain covered Part D drugs at a network pharmacy, Part D plans are required to assure that their enrollees have adequate access to drugs dispensed at out-of-network pharmacies. In addition, in circumstances where normal distribution channels are unavailable, Part D plans are expected to liberally apply their out of network policies to facilitate access to medications.

-- Wayne R. Lindley, California SHIP-HICAP Director