If you have been getting a Medicare Part D (Prescription Drug) coverage you may or may not have encountered the term “Transition Fill” or “Transition Refill”. It is not for new prescriptions but rather a supply of non-formulary drugs you had been taking before you switch your plan or your plan changed/dropped your formulary by changing its coverage or putting some restrictions.
A “Transition Fill” is a one-time 30-day non-formulary drug supply that allows safe transitions of drug therapy since there is continuity in the taking of medication rather than an abrupt cessation of coverage which could lead to a rather bad effect on the health of the medication taker. This transition is valid only for 90 days after your new coverage starts and is not free. You will need to pay your share of the cost associated with these medications.
The beneficiary, during the transition period, should work with their doctor for the options he or she has regarding medications. Take action immediately to avail this policy (like paperwork, requests, and such) otherwise after your thirty day supply ends, you’ll be left to pay for the whole amount of your medications. For long-term care (LTC) facilities or nursing homes, there are a different set of rules to be followed that could often provide non-formulary drugs at least 91 days or so.
This policy includes all Part D (Prescription Drug) plans, as well as Medicare Advantage Plans, that includes a Part D prescription drug coverage.
For more information regarding transition refills, contact your doctor and your plan’s coverage provider.