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Appointed Representative: An appointed representative is any person, such as a relative, friend or doctor who is appointed by the Medicare beneficiary to act on his/her behalf in the appeal process.
Beneficiary: A beneficiary is an individual who has benefits under Medicare.
Brand Name, single-source (drug): A brand name is a one of a kind drug that is still being protected by a patent. There are no other medicines exactly like it on the market.
Claim: A claim is a paper or electronic form sent to the PDP to show that a covered product or service was provided to a beneficiary and that payment is needed.
Co-Insurance: Co-Insurance is a percentage of the cost of a health service, for example 30% paid by the beneficiary.
Co-pay or Co-payment: A Co-pay is a fixed amount payment, for example $15m that an insured individual pays for medicines or health services, regardless of the actual cost of that medicine or service.
Contraindication: Contraindication is also called a drug interaction or adverse event. A warning that a medicine may react badly with another medication you are presently taking or because of different medical condition you have.
Coverage determination: A coverage determination is when a person asks for a coverage determination, the PDP(prescription drug plan) will decide or determine whether to pay or not to pay for your medication because it is medically necessary even if it would be against the plan's rules to actually pay for it. The decision is called an exception.
Coverage Gap: The coverage gap, which is sometimes called the donut hole, is the time when Medicare temporarily stops paying for your prescriptions and you have to pay the entire cost yourself.
Covered Drug: A covered drug is a medicine that your plan pays at least part of the cost at some time during the year.
Deductible: A deductible is an amount a beneficiary must pay for health care services before their Medicare prescription drug plan begins to pay any benefits. Medicare PDPs will generally have a $250 deductible.
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Exception: The first step in the appeal process is to request an exception. This is also called asking for a coverage determination in official Medicare terms. Asking for an exception means that you are asking the PDP to bend its rules and pay for a medication it would not normally pay for.
PDPs may have rules such as a formulary or even step therapy requirements that prevent them from paying for some prescription drugs unless you get an exception. Or you may appeal further and win your appeal. PDPs also may have tiered co-pays.
If your medication is in the highest copay tier and you cannot take any medications in a lower copay tier that treat your condition, then you can ask for an exception from the copay rules. If you are granted an exception from the copay rules then you will pay a lower copay price for that particular medication than you would normally pay.
Formulary: Formulary is a list of prescriptions established by a PDP to show which prescription drugs they cover and at what copay amount.
Generic Drug: A generic drug is a prescription drug that is a copy of a brand name drug. When the brand name prescription drug is no longer protected by patent many companies can make a copy and manufacture the drug with the same active ingredient and the original prescription. A generic should produce the same effect that the brand name medicine produced.
Mail Order, Mail Order Pharmacy: With a mail order pharmacy your prescriptions are received in the mail from your PDP.
Medicare Advantage Prescription Drug Plan (MA-PD plan): Medicare Advantage plans or MA plans must offer their enrollees pharmacy benefits in addition to basic health care coverage. Enrollees may choose whether to purchase these additional benefits, which are called the Medicare Advantage Prescription Drug Plan. Individuals enrolled in a MA plan may only purchase their pharmacy benefits from the MA-PD plan offered by their MA plan.
Out-of-Pocket Thresh hold or Limit: The out-of-pocket threshold is the upper limit on how much an individual beneficiary must pay in a year for medicines before catastrophic coverage begins. In 2006, this amount will be $3600 for Medicare prescription drug plans. Once the limit is reached, co-payments will be much lower.
OTC Drugs: Over-the-counter or OTC drugs can be purchased without a prescription and are generally not paid for by insurance.
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Pharmacy Benefit Management Company (PBM): A pharmacy benefit management company is a Company that manages pharmacy benefits and may assist an insurer in providing a Medicare PDP or MA-PD plan. ''' Prescription Drug Plan'''(PDP): A Prescription Drug Plan available through Medicare Part D must provide certain minimum benefits and consumer protections. They may be offered by insurance companies, Medicare Advantage plans or Pharmacy Benefit Management Companies.
Prior Authorization: Prior authorization is a requirement that a physician get prior approval from the prescription drug plan before the plan will pay for the prescription medicine.
Re-determination: If a PDP refuses to give you an exception, the next step in the appeal process is to request that the PDP reconsider that decision. This is called a re-determination. You can be sure that your request will get a fresh look because the doctor making the decision on the re-determination cannot be the same person that originally denied your request for an exception.
Step Therapy: Step Therapy is a requirement to try a more inexpensive medicine first to see if it works, before a more expensive prescription medication may be paid for by the prescription drug plan.
Therapeutic Substitution: Therapeutic substitution is the process of switching an existing prescription to a different and usually less costly prescription medicine that is chemically different(not a generic), but is used to treat the same clinical condition.
Tiered Co-pay (co-payments): A tiered co-payment is a co-payment that is determined by which tier the drug is assigned to by the prescription drug plan. There may be a few tiers with each having a different copay amount. This design is to encourage the use of prescription drugs that are in a less expensive category.
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