Receiving a temporary supply of prescription drugs
If your prescription drug is not on our Approved Drug List or is on the formulary but is restricted in some way, you may receive a temporary supply of this drug at any in-network pharmacy during your first 90 days in the plan to allow you and your doctor to find another option.
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 to ask Priority Health to cover the drug for you.
Eligibility
Before attempting to fill a temporary supply of your non-covered prescription, first find out if you're eligible.
- If you're new to a Priority Health 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.
How to fill
If you know you're eligible to receive a temporary supply, find out how to order one.