Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.
A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.
A Medicare drug plan can make some changes to its formulary during the year within guidelines set by Medicare. If the change involves a drug you’re currently taking, your plan must do one of these:
Starting in December 2015, for your prescriptions to be covered by your Medicare drug plan, Medicare will make sure your prescribers are enrolled in Medicare or have an “opt-out” affidavit on file with Medicare. Contact your plan or your prescribers for more information.
Payments throughout the year in a Medicare drug plan:
Mark B. Murphy
Senior Medical Solutions
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