Medicare Prescription Drug Coverage - Medicare Drug Plans & Pharmacies

Prior Authorization

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Some prescription drugs are more expensive than others even though some less expensive prescription drugs work just as well. Other prescription drugs may have more side effects, or have restrictions on how long they can be taken. To be sure certain prescription drugs are used correctly and only when truly necessary, plans may require a “prior authorization.” This means before the plan will cover these prescriptions, your doctor must first contact the plan and show there is a medically-necessary reason why you must use that particular prescription drug for it to be covered.