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Why isn't my medication covered by Medicare Part D

From About.com

Created: February 12, 2006

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Question: Why isn't my medication covered by Medicare Part D

I don't understand who to appeal to if one of my medications isn't covered in the AARP formulary. I am being referred to a non-working number in FLA, my pharmacy and AARP general info (where I get "bumped -off.") I take the generic version of Klonopin, called clonazepam 0.5 mg tablet. I don't understand why none of the plans don't cover it. I have been taking it for years. I am told that none of the plans cover a similar drug. Any referrals appreciated.

Answer: When the bill that instituted Medicare Drug coverage was passed by Congress in 2003, certain classes of drugs were excluded from coverage including the class of drugs known as benzodiazepines. Klonopin (generic name clonazepam) falls within this class of drugs. Other common drugs in this class are Valium and Librium. The main action and use for this class of drugs is as a central nervous system inhibitor - they reduce anxiety. They can also result in physical dependency. While Klonopin is in this chemical class of drugs it is approved for treating certain types of seizures (absence, atypical absence, akietic and myoclonic seizures).

Because this drug is excluded none of the plans will cover it. You should talk with your doctor immediately and discuss this drug and find out if there is any other type of drug that you can take instead of this one. If this drug is the only one that will work for your needs, you might contact your state department of health and see if you qualify for coverage under Medicaid (some states will continue to provide coverage for medications excluded under the new plan). If you are not eligible you may try shopping around for the best price. Check out some of the online pharmacies - the prices for the generic version of this drug are very reasonable.

If you still have questions or compliaints about your Medicare Part D coverage you can contact Medicare directly at 1-800 MEDICARE (1-800-633-4227).

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