What Are the Medicare Safety Reviews?

A safety review is a check that a plan and/or pharmacist may do if you fill a prescription for certain medications, such as an opioid pain medication.

The safety review may be for:

  • Potentially unsafe opioid amounts
  • Opioid use with benzodiazepines
  • New opioid use (in which case, you may be limited to a seven-day supply or less)

If your pharmacist cannot fill the prescription because it is deemed unsafe, the pharmacist should give you a notice about how to request a coverage determination from the plan. Requesting a coverage determination is the first step you must take before beginning the appeal process. If the plan denies coverage, you can begin an appeal to ask your plan to cover the drug. If possible, you should contact your doctor for support with an appeal.

Read More: What Places Are Covered Under Medicare if I Need Mental Health Care or Addiction Recovery Services?
Learn About: How Does Medicare Work With Behavioral Health Care?
Return to: Medicare In-Depth

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