Fill a temporary supply of a drug that isn't covered
If your prescription drug is not on our Approved Drug List or if your ability to get your drug is limited, you may fill a temporary supply (up to 30 days) of your drug at any in-network pharmacy to allow time to talk to your doctor about your options.
What is a temporary supply?
A temporary supply, or "transition fill," gives you and your doctor or other health care provider time to change to another drug or to file a request, also known as a "coverage determination," to have Priority Health cover the drug for you.
Before attempting to fill a temporary supply of your non-covered prescription, first find out if you're eligible.
- If you're new to your Medicare plan and the drug you are currently taking is not on the Priority Health Medicare formulary, or is on the formulary but is restricted in some way, you are eligible for a temporary supply. You have 90 days from the day your plan starts (your "effective date") to get a transition fill.
- If you're a current member of a Priority Health Medicare plan and the drug you have been taking is no longer on the plan's formulary or the drug you have been taking is now restricted in some way (See Section 5, Chapter 5 of your EOC for more information about restrictions), you are eligible for a temporary supply. You have 90 days from the day your plan renews to get a transition fill.
- If you're a member of a Priority Health Medicare plan and live in a long-term care facility, you have 90 days from your admission date to the facility to get a transition fill.