MEDICARE PART D DRUG COVERAGE
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As a Medicare-certified hospice provider, we would like to inform you about changes to the Medicare Part D drug coverage from the Centers for Medicare and Medicaid Services (CMS). Part D drug coverage includes medications taken by a patient prior to enrolling on hospice service for which the pa - tient’s Part D provider paid. If you have Medicare Part D drug coverage, your pharmacy must bill all your medications to the hospice provider, to determine whether they are covered under the Medicare Hospice Benefit or the Part D Plan. What this means for you • Four Seasons Hospice will pay for all medications that are related to your hospice condition or illness, including all medications related to improving your symptoms. • For medications that are unrelated to your hospice condition, Four Seasons is required to submit a Prior Authori - zation Form to your Part D Provider. When this is completed, you will likely be able to receive your unrelated medications as usual. • Our hospice providers will work with you and your primary care provider to determine the value of continuing medications that may or may not be medically necessary for your condition. Many people feel better when they stop taking medications because of potential side effects and medication interactions. • If a medication is determined to be related to your hospice condition, but not medically necessary, this medication will NOT be covered under the Hospice Benefit or the Part D Plan. • You can choose to continue medications that are not covered under the Hospice Benefit or the Part D Plan, but you will be financially responsible for paying for these medications (also known as paying “out-of-pocket”). • Four Seasons has a recommended formulary. A hospice medical provider may change a medication you are cur - rently taking to a different medication in the same category. The new medication will have the same efficacy as the one you have been taking. If you choose to continue the medication you have been taking, you will be finan - cially responsible for paying for this medication. Four Seasons is committed to providing the best care and treatment for you and your family during your hospice jour - ney. If you have questions or concerns, please call us at 828.692.6178.
866.466.9734
FourSeasonsCare.org
Four Seasons
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