Learn More About Prescription Drug Plans

At Get Best Medicare we do our best to answer your questions about Medicare. Today we’re going to tackle what Medicare drug plans (or prescription drug plans) cover. It’s important to know what is and isn’t covered by your Medicare provider to help you make wise decisions regarding your health and your budget.

Each Medicare Prescription Drug Plan comes with its own list of covered prescription drugs, which are referred to as formulary. Most Medicare drug plans (Medicare Part D) organize prescription drugs into different tiers or levels, based on their formularies. Prescription drugs are priced differently per tier.

Prescription Drug Tiers

A prescription drug placed in a lower tier generally costs less than a drug in a higher tier. In certain cases, you or your doctor can ask your Medicare plan for an exception to get a lower copayment on a drug on a higher tier if you need that specific drug over a drug in a lower tier that costs less.

Medicare Part D Updates

A Medicare prescription drug plan is able to make changes to is formulary during the year as long as they fall within guidelines set by Medicare. If the prescription drugs you are taking are affected by price changes, your Medicare plan must do one of the following:

Give you written notice at least 60 days prior to the price change

Provide you with a written notice of the change at the time you request a refill, and allow a 60-day supply of the drug under the previous plan rules

Medicare Prescription Drug Plans

All Medicare beneficiaries are entitled to Medicare part D. Medicare beneficiaries who are enrolled in Medicare Part A and/or entitled to Part B are eligible for Part D as well. There are two important documents all Medicare Part D customers receive:

Formulary, or list of covered drugs

Pharmacy directory listing network pharmacies that have agreed to fill prescriptions covered for plan members

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