Choosing a Part D Plan? Can You Say Formulary?
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Whether your choosing a standalone prescription plan, or a plan that’s part of a Medicare Advantage plan, you’ll need to know what they cover and for how much. That’s where the formulary comes in. A formulary is a list of prescription drugs covered by a drug benefit plan. It’s usually a long list of drugs with brand names and generic names, whether they’re covered by the plan and how much you might pay in terms of a copay, or a percentage of the price. You may pay varying copays for drugs that are on the formulary. Sound complicated? It can be, but it’s not insurmountable.
A great place to start is with the Medicare Formulary finder. The finder works by selecting your state and then finding and selecting each of your regular prescription medicines. You then set the prescription quantity for each one. Once you’ve done all that, the site should list the plans that cover all your medicines and then in a second list it could show you plans that only cover a portion of your prescriptions.
That should give you an idea of what plans might be a good bet. The Medicare site can also direct you to the provider’s site where you should be able to download the full formulary (go here). It’s a good idea to double check the provider’s list against the Medicare site.
Spending a little time reviewing formulary drug lists, fees and policies can save money and help avoid the coverage gap.
Here are some other resources that might help:
- How Medicare Drug Plans Use Pharmacies, Formularies, and Common Coverage Rules (PDF).
- Consumer Reports – Buzzword: Formulary
- HowStuffWorks – How Prescription Drug Benefits Work
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[...] Whether your choosing a standalone prescription plan, or a plan that’s part of a Medicare Advantage plan, you’ll need to know what they cover and for how much. That’s where the formulary comes in. A formulary is a list of prescription drugs covered by a drug benefit plan. It’s usually a long list of drugs with brand names and generic names, whether they’re covered by the plan and how much you might pay in terms of a copay, or a percentage of the price. You may pay varying copays for drugs that are on the formulary. For more on our post click here. [...]