Part D Pharmacy Networks •Part D coverage is generally provided through contracted pharmacies (network pharmacies) in the Part D plan’s service area, except that PFFS plans are not required to [...]
How do I appeal a coverage decision made by my Medicare Part D plan? If you disagree with a coverage decision made by your Medicare Part D plan, you have [...]
Formularies •Part D plans generally do not cover all drugs available in each category of Part D covered drugs because in some cases several similar drugs are available to treat [...]
Part D Drug Management Tools In addition to formularies and cost sharing tiers, Part D plans use a variety of prescription drug benefit management tools including: •Step therapy: One or [...]
Part D Cost – How much do I pay Part D? Your drug costs will vary based on the plan you choose. Remember, plan coverage and costs can change each [...]
Employer/Union Coverage of Drugs •Employer or Union Coverage: Employers/unions will notify their employees of whether their non-Medicare prescription drug coverage is “creditable” (coverage that, on average, equals at least as [...]
Part D cost for High Income People whose income exceeds certain thresholds pay more for Part D plans. This extra premium amount is called the Income Monthly Adjusted Amount (IRMAA) [...]
