What happens if a drug you take is not on the Formulary (drug list) or is listed as restricted in some way (such as needing Prior Authorization)?
You may be able to get a temporary supply of the drug if you qualify.
This temporary supply is called a Transition Fill. This allows you to continue taking your medication without interruption and gives you time to talk to your doctor. You and your doctor need to decide what to do when your temporary supply
runs out. There may be a different drug that is covered by the plan that might work just as well for you which may cost less. Otherwise, you or your doctor can ask Quartz Medicare Advantage to cover the medication that you are currently
taking. A Coverage Determination Request may be submitted to start this process.
To be eligible for a Transition Fill, you must meet the two requirements below:
1. The change to your drug coverage must be one of the following:
2. You must be in one of the situations described below:
During the time when you are getting a temporary supply of a drug, you should talk with your doctor to decide what to do when your temporary supply runs out. Perhaps there is a different drug covered by the plan that might work just as well for you. Or you and your doctor can ask the plan to make an exception for you.
If you have any questions, please contact our Customer Service Department. You may also call through a video relay service company of your choice. Interpreter services are provided free of charge to you.
For more information, you can review the Quartz Medicare Advantage Part D Drug Transition policy.