Medicare and Me: Mail order drugs


Leah Kari, Certified Medical Representative

Do you like the convenience of receiving your prescription drugs through the mail order feature of your Medicare Part D prescription drug plan? Do you dislike having to call the mail order pharmacy to request your refills? Are you wondering why the plan doesn’t just send your prescriptions every 90 days without requiring you to contact them to authorize your refill?

You’re busy, and if you are like me, you automate as much of your daily routines and responsibilities (such as ordering your meds) as you possibly can. Here’s some information that may be useful for you.

Medicare prescription drug plans must have your approval to deliver a prescription drug (new or refill) unless you ask for the refill or request the new prescription.

Some plans may ask you for your approval annually so that they can send you your drugs without asking you before each refill delivery.

Other prescription drug plans offer an “automatic refill” service that automatically delivers prescription drugs when your prescription is about to run out.

Certain plans may ask you before every delivery. This policy doesn’t affect refill reminder programs where you go in person to a retail pharmacy to pick up the drug, and it doesn’t apply to long-term care pharmacies that dispense and deliver prescription drugs. (1)

Call your plan’s mail order pharmacy or visit the plan’s pharmacy section on their website to see what features are available to you. You’ll learn the best way to make the refill process go smoothly. The plan may suggest downloading an application if you are a smart phone user that you use to authorize refills. Be sure to give your pharmacy the best way to reach you, so you don’t miss the refill confirmation call or other communication.

Lastly, should you ever receive any unwanted or unordered prescription drugs through an automated delivery program, contact the plan’s mail order pharmacy immediately to investigate for fraudulent use of your information. If you receive a refill for a medicine you’ve canceled or changed, you may be eligible for a refund for the amount you were charged. If you aren’t able to resolve the issue with the plan or wish to file a complaint, follow the instructions in your plan’s Evidence of Coverage to file an appeal. If your situation cannot be resolved, contact 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. (2)

Leah Kari is a licensed life and health insurance broker focusing on showing Medicare eligible or people on Medicare their senior health care options, and was a pharmaceutical representative in Los Angeles for 16 years.

(1) Your Guide to Medicare Prescription Drug Coverage, Revised June 2018, page 25, Section 2, paragraphs 1-4: “How Medicare Drug Coverage Works.”

(2) Ibid: page 25, Section 2 paragraph 5