@irenea8 My doctor told me that Brinsupri is an exception only drug and requires a PA. Brinsupri is not on any drug formulary and will not be for 2026. That's why Brinsupri is an exception [PA] drug. Medicare knows about the drug as Insmed has negotiated with them. It might well be, but I do not know for sure, that any Part D drug plan you select will have to "cover" Brinsupri, as Insmed has negotiated this with Medicare.

Have you run this dilemma by a SHIP Medicare volunteer in your area? It seems to me that if your doctor submits a PA your drug plan has to approve the drug, assuming it's medically necessary and there are no lower cost substitutes. There aren't! Your SHIP contact could verify this.

Another idea to call Insmed and speak with an educator or Inlighten co-ordinator, 833-544-4800, ask for the contact information of the speciality pharmacy in your area, contact that pharmacy and find out which insurances they have successfully dealt with. They tend to be very helpful. Another idea, is to contact the NP or PA in the doctor's office to look up other patients under the doctor's care who are on Brinsupri and to see what drug insurance plan they have?

Personally, I'd start with SHIP or Insmed and last resort the doctor's office. Perhaps others can weigh in on their experiences. I really hope you can sort through this and let us know what you find out. I truly hope you can start Brinsupri and that it benefits you as much as it has benefited me.