# io.github.builtforai/coverage-exception

> Why Medicare Part D restricts a drug, and the exception and appeal path to challenge it

- name: io.github.builtforai/coverage-exception
- version: 1.0.0
- connection class: R0 (autonomous)
- trust: 90/100 flags: duplicate-repo
- quality: 79/100 (good)
- owner: not claimed
- descriptor: https://api.protogrid.dev/v1/servers/io.github.builtforai%2Fcoverage-exception
- tools: https://api.protogrid.dev/v1/servers/io.github.builtforai%2Fcoverage-exception/tools

**An agent can connect right now, no human step.** Remote endpoint, no authentication, reachable on the last probe.

## Connection (mcpServers)

```json
{
  "mcpServers": {
    "coverage-exception": {
      "type": "http",
      "url": "https://insurewith.ai/mcp"
    }
  }
}
```


## Trust

- hygiene: 80
- liveness: 99
- freshness: 85
- provenance: 90
- drivers: +repository +namespace-matches-repo +website +reachable +uptime-98% ~updated-31d-ago -duplicate-repo(5 names)
- Derived from observable signals (official registry feed and our own credential-free probes); no code audit performed.

## Quality 79/100 (good)

### protocol: 75 (weight 25)

- warn `protocol.modern`: newest supported version is 2024-11-05; 2026-07-28 not supported, older versions are deprecated until 2027-07-28
- n/a `protocol.stateless`: only applies to 2026-07-28 servers
- pass `protocol.transport`: streamable HTTP
- n/a `protocol.list_ttl`: only applies to 2026-07-28 servers

### authorization: n/a (weight 15)

- n/a `auth.prm`, `auth.as_metadata`, `auth.cimd`: no remote uses OAuth
- n/a `auth.secret_in_url`: no templated URL

### tool hygiene: 71 (weight 30)

- pass `tools.descriptions`: every tool has a description
- pass `tools.description_length`: descriptions are concise
- pass `tools.schemas`: every tool has an object input schema
- fail `tools.annotations`: no tool declares readOnlyHint or destructiveHint, so clients cannot tell safe calls from risky ones
- fail `tools.directory_hints`: no tool declares all four of readOnlyHint, destructiveHint, idempotentHint and openWorldHint; missing: medicare_coverage_restriction_and_exception (readOnlyHint, destructiveHint, idempotentHint, openWorldHint); medicare_part_d_out_of_pocket_cap (readOnlyHint, destructiveHint, idempotentHint, openWorldHint)
- pass `tools.token_cost`: about 500 tokens to load every tool
- pass `tools.api_dump`: tools are not a one-to-one API dump

### stability: 100 (weight 15)

- pass `stability.changes`: no tool changes in 30 days
- pass `stability.rug_pull`: no tool changed its meaning under the same name

### dependencies: n/a (weight 15)

- n/a `deps.known_vulns`, `deps.mcp_sdk_version`, `deps.resolvable`: no npm or PyPI package

- tools: 2, about 500 tokens to load them all
- tool set hash: bfa9d924e31b00879f1fb80006083588
- badge: [![protogrid quality](https://protogrid.dev/badge/io.github.builtforai/coverage-exception.svg)](https://protogrid.dev/servers/io.github.builtforai/coverage-exception)
- Checks run on what our credential-free, read-only probes observe; tools are never called and no code audit is performed.

### Tool changes

_No tool definition changes recorded._

## Remotes

- https://insurewith.ai/mcp (streamable-http, auth none, reachable true, uptime30d 0.9826087)

## Packages

_none_

## Tools (2)

- `medicare_coverage_restriction_and_exception`: 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.
- `medicare_part_d_out_of_pocket_cap`: 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.