1 10-minute claim is based solely on the time to complete the e-application if you have your Medicare card and other pertinent information available when you apply. The time to shop for plans, compare rates, and estimate drug costs is not factored into the claim. Application time could be longer. Actual time to enroll will depend on the consumer and their plan comparison needs.
Common Questions
What Are Medicare PA forms?
Medicare Advantage plans often come with prescription drug coverage. In some cases, you may need to submit prior authorization forms, also known as Medicare PA forms.
Medicare Part D plans come with prescription drug coverage. Sometimes there are simple additional steps you need to take in order to get your prescription medication filled.
Here, you’ll learn about prior authorization forms, also known as Medicare PA forms.
When you need prior authorization
As a precaution, Medicare Part D prescription drug plans may require that you gain prior authorization for prescription drug coverage.
Learn More About Medicare
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
You can get this authorization by submitting a PA form.
These forms allow insurers to review certain prescriptions before offering coverage. The process is built on the understanding that:
- Some drugs can be dangerous when mixed with other drugs
- Some drugs are addictive or prone to misuse
- There are drugs that might be equally effective, but which vary greatly in price
- Some drugs should only be used for certain health conditions
Insurers want to make sure that you’re getting the best possible treatment.
Insurers also want to make sure you’ll remain safe while taking certain prescription drugs. Medicare PA forms provide an important measure of patient protection.
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.1
Enroll in Medicare Part D at MyRxPlans.com
Visit MyRxPlans.comHow it works
If your drug requires prior authorization, you’ll likely need to send a prior authorization form to your insurer. This will likely include:
- Basic information about you
- Your primary care physician’s name
- A copy of your provider’s signature
- Information about the prescription drug, including the dosage
You’ll need to send this information to your insurer, who will review the form and decide whether to authorize coverage for the drug.
Plans that cover prescription drugs include what’s known as a formulary. This is a list of drugs covered by your plan.
Reviewing the formulary will help you understand whether you’ll need to fill out a Medicare PA form for coverage, or whether the drug will automatically be covered.
Other considerations
You can always talk to your physician to see whether there’s a comparable drug that doesn’t require prior authorization. Additionally, your pharmacist can assist, too.
If you have questions about how Medicare PA forms work with your specific Medicare plan or to compare Medicare plans in your area, call today to speak with a licensed insurance agent.
Compare Medicare Advantage plans in your area
Compare PlansOr call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
