Medicare Part D Plan Formulary

If you rely on medications, it’s important to review each Part D plan’s formulary, to confirm the prescriptions you need are listed.

Each plan has its list of covered prescription drugs, called a formulary. Medications are classified into tiers, the lowest costing less than those in higher tiers. Be sure to check that your medications are listed. If you don’t see yours listed, search for another plan. These lists often change yearly, meaning your medications may no longer be available next year. Prescription drugs change tiers or move between classifications. Even if you are happy with your coverage, you must review the Annual Notice of Change for the upcoming year to avoid being surprised at the pharmacy.

Tier 2 – Preferred, brand-name, medium copayment

Tier 3 – Non-preferred brand name, higher copayment

It’s important to know which medications will be covered under the plan, and which are not. Part D does not provide coverage for over-the-counter medications, including cough and cold medicine, and vitamins. Medicare covers some medications that Part D does not. For instance, vaccines, cancer drugs, and certain injectable drugs are covered under Part B if you receive them in an outpatient setting, like your doctor’s office.

In the event your medications are not covered under the plan, there are things you can do.