7. How can a SHIP learn about a Part D plan's exceptions process?
There are several ways to learn about the plan's exceptions process. According to the MMA Regulations:

• Part D plans are required to post the "process for obtaining an exception to a plan's formulary or tiered cost-sharing structure" and "grievance, coverage determinations, and appeals procedures" on their exceptions and appeals process on their websites (p. 4272);
• Plans are also required to provide this information to enrollees at the time of enrollment and at least annually thereafter in a "plan description" (p. 4539). SHIP counselors can ask to see their client's plan description;
• Finally, plans are required to provide this information “upon request of a Part D eligible individual” (p. 4539). SHIP counselors and the client can call the plan together to obtain such information.

(Back toe Questions about Exceptions and Appeals)