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AARP Medicare Prescription Plan / Changing drug tiers without notice

1 NY, United States Review updated:

AARP refused to pay for my prescription for Sular. I read the 2009 Formulary book sent to me in late December of 2008 for the year 2009. Sular was listed as a Tier 2 drug. I ordered a 90 day supply Janauary 6, 2009. The provider called and advised it was not covered.

I called AARP and was informed the drug was now a tier 3 drug and they would not pay. I asked when the change was decided as I just received their formulary guide. I was told the FDA changed it. I asked how I am supposed to know this change occured when they just mailed my new 2009 packet. No response. I advised them I am now locked into a prescription plan for part D of Medicaid for the next year and they will now not cover my prescription. I was told to ask my doctor to call and they will present his reason why I need this drug to a review board who will then vote to see if it will be accepted. That will cost me another $300 for an office visit and I still not may get the coverage they informed me I had. I do not know if I am writing to the correct site.
Anthony Trombetta
[protected])
114 Eastwood Avenue
Deer Park, NY 11729

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Comments

  • H2
      11th of Aug, 2009
    0 Votes

    A not so known fact is that if the FDA deems it needed to change a medication's coverage, a member will not receive the 60 day notification that is required of any medication changes in the middle of the year. However I completely disagree that the tier 3 prices should be charged within that same year, because a member has no control over the changes that were made.

  • Ca
      6th of Dec, 2010
    0 Votes

    Hi'
    I had the same problem with my Sular prescription, My Doctor called their no. but they still said no coverage!
    Seems none of the insurances I could check carry Sular in the year 1211, Now what should I do? It's the only one that works for me. Any advice?
    C.S.

  • Gs
      22nd of Jan, 2011
    0 Votes

    Every year at this time i have to fight for medications that work for me.Im about to lose my zoloft, flonaze, allegra, for generics.These medications work for me.I have gotton to old '63' to try new medication. I need to file a complaint but where?

  • Le
      25th of Mar, 2014
    +1 Votes

    I was told my drugs were covered and I would not be in the "donut hole". I was given bad advice by AARP sales rep. No recourse.

    Another bad piece on advise when I called to complain, I was connected to the online pharmacy. They had a generic drug to replace the Elmiron prescribed by my doctor and told me it would be the generic of Elmiron. There is no generic for Elmiron and this could cause me harm. No not listen to AARP advice.

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