Missouri Medicare Part D Emergency Override Authorization Plan

MO HealthNet’s Medicare Part D Emergency Override Authorization Plan is designed to provide assistance with prescription drug coverage to individuals who have been unable to receive prescription drug assistance through Medicare Part D.

The program must be accessed by a provider, and the provider must provide information about the attempts made to access prescription drug assistance through Medicare Part D, including contacting Medicare and/or the individual’s Prescription Drug Plan.

The individual seeking assistance through their provider must be eligible for BOTH MO HealthNet and Medicare.

Eligibility for the Medicare Part D Emergency Override Authorization Plan:

Steps to follow BEFORE submitting the Medicare Part D Emergency Override Authorization Plan Claim Form:

Steps To Complete The Medicare Part D Emergency Override Authorization Plan Claim Form: