Five Days Into the Medicare GLP-1 Bridge, Eligible Seniors Are Being Denied at the Pharmacy Over a Billing Disconnect, Not Eligibility
A Medical Daily report on July 6 found that eligible Part D beneficiaries are walking away from pharmacy counters without their GLP-1 prescriptions five days after the Bridge launched July 1. The rejections stem from a technical routing problem: when a pharmacy submits the claim through a patient's normal Part D plan, it is automatically denied. The fix is to route the claim through Humana's central processor using BIN 028918 and PCN MEDDGLP1BR, a detail many patients and pharmacists were unprepared for.