- A Medicare formulary is a list of prescription drugs that are covered under a Medicare PDP. Medicare formularies vary depending on the specific PDP a beneficiary is enrolled in and may include drugs that are covered by the plan, as well as any restrictions or limitations on coverage.
- If a beneficiary is enrolled in a Medicare PDP, it is important to be aware of the formulary for their plan. The formulary can help a beneficiary understand what prescription drugs are covered by their plan and what costs they may be responsible for paying for these drugs. For example, a formulary may include information about whether the beneficiary is required to pay a copayment or deductible for a prescription drug, or whether there are any limits on the number of prescriptions that can be filled for a particular drug.
- It is important to note that Medicare formularies can change from year to year, and a PDP may add or remove drugs from the formulary or change the cost-sharing requirements for certain drugs. If a beneficiary is taking a prescription drug that is covered by their PDP, it is a good idea to review the formulary each year to ensure that the drug is still covered and to understand any changes to the cost-sharing requirements.
- If a beneficiary has any questions about their Medicare formulary or about their prescription drug coverage, it is recommended that they contact their PDP or speak with a Medicare representative. The beneficiary may also want to discuss their coverage with their healthcare provider to ensure that they understand the treatment
options and any potential out-of-pocket costs.
