coverage-exception
Why Medicare Part D restricts a drug, and the exception and appeal path to challenge it
我该使用它吗
质量与安全性
发现（2）
- LOWTool 'medicare_part_d_out_of_pocket_cap' name length outside 3-30 range在 medicare_part_d_out_of_pocket_cap 中
- LOWTool 'medicare_coverage_restriction_and_exception' name length outside 3-30 range在 medicare_coverage_restriction_and_exception 中
基于对工具定义和协议合规性的自动分析。
上下文开销
这是每次将服务器的工具加载到模型上下文窗口时所消耗的大致 token 数。数值越高，可用于其他任务的注意力就越少。
安装
一键安装
将以下内容添加到你的 `claude_desktop_config.json` 文件中：
{
"mcpServers": {
"coverage-exception": {
"url": "https://insurewith.ai/mcp"
}
}
}远程端点
https://insurewith.ai/mcpstreamable-http它能做什么
工具清单
工具（2）
⚪medicare_part_d_out_of_pocket_cap(monthly, drug, deductible, join, year)
Project month-by-month Medicare Part D out-of-pocket spending against the statutory annual cap, identify the month the cap is reached, quantify what the cap itself saves, and compare normal payment timing against the Medicare Prescription Payment Plan — which spreads the SAME total across the year without reducing it. Supports plan years 2026 and 2027 and fails closed to 2026 for any unsupported year rather than extrapolating. This is a standard-benefit simulation, NOT a plan-specific pharmacy quote: plan negotiated prices and plan cost sharing are not held and are never inferred.
输入模式
{
"type": "object",
"properties": {
"monthly": {
"type": "string",
"description": "Expected monthly out-of-pocket spend on covered drugs, in USD, e.g. \"300\""
},
"drug": {
"type": "string",
"description": "Optional drug name — checks formulary status and whether spending on it counts toward the cap"
},
"deductible": {
"type": "string",
"description": "Optional plan drug deductible in USD, e.g. \"615\" or \"0\""
},
"join": {
"type": "string",
"description": "Optional month (1-12) the payment plan would be joined"
},
"year": {
"type": "string",
"description": "Optional plan year: 2026 or 2027"
}
},
"required": [
"monthly"
]
}🟡medicare_coverage_restriction_and_exception(drug, state)
For a drug on Medicare Part D, name the coverage problem — covered, prior authorization, step therapy, quantity limit, or not on formulary — and give the exception and appeal path with the CMS-named levels of appeal, who must submit the request, and what to ask the plan and the prescriber. Returns per-plan flag counts across plans held. Plan-specific clinical criteria and appeal deadlines are NOT held and are never inferred; they are returned in an explicit "unavailable" block rather than guessed.
输入模式
{
"type": "object",
"properties": {
"drug": {
"type": "string",
"description": "Brand or generic drug name, e.g. \"Humira\", \"adalimumab\""
},
"state": {
"type": "string",
"description": "Optional 2-letter US state code, e.g. \"TX\""
}
},
"required": [
"drug"
]
}社区
证据