Physicians, patients or a patient's representative can pursue the appeal process if the Medicare drug plan won't cover medicine. Appeals must be filed within 60 days of receiving a denial at the previous level.

If the patient can afford to pay for the medicine up front, the appeal can still be made but there won't be a 24-hour review. If the appeal is won, the cost will be reimbursed. The patient's doctor must be actively involved. Some plans go sp far as requiring doctors to supply medical journal articles to justify the prescription for expensive drugs.

If an appeal is denied, the patient can ask the drug plan to reconsider. If there is another rejection, it may be necessary to get legal help. One place to look for advice is your State Health Insurance Assistance Program (SHIP).