The type of coverage provided by a Medicare Part D prescription drug plan varies from plan to plan. Each plan has its own unique list of prescription drugs that it covers, which is referred to as a formulary. Within the formulary, these drugs will often be divided into several different tiers, typically to indicate cost differences.
Drugs within a lower tier will cost less to purchase. In the event that a prescription drug you need is in a higher tier, it’s possible that the doctor prescribing the medication can ask for an exception so that you can pay a lower copayment. While enrolled in a Medicare Part D plan, it’s possible for the formulary to change. If so, you will need to receive a written notice of the change within 60 days of it taking affect.