After the links just below to introductory materials and the CMS "Formulary Finder" tool, there are additional, more detailed materials explaining WHAT DRUGS ARE COVERED, WHAT DRUGS ARE EXCLUDED, and WHAT LIMITS PLANS CAN PLACE ON DRUGS INCLUDED IN THEIR PLANS.

• Medicare Q&A Weekly Column on Drug Coverage, Limits, and Appeals [Fact Sheet]   Source: Kaiser Family Foundation

English     

A brief description of questions to ask about what drugs are included in a plan, how much they will cost, and what the limits or restrictions are.

WHAT DRUGS ARE COVERED?

• Which Drugs Does the Medicare Benefit Cover? [Interactive Tool]   Source: Medicare Rights Center

English     

Explains drug formularies, exceptions to the formularies and requirements for "prior authorization".

• Tip Sheet: Medicare Drug Coverage under Medicare Part A, Part B, And Part D [Fact Sheet]   Source: Centers for Medicare and Medicaid Services

English     

Explains what drugs are and are not covered under these parts of the Medicare program.

WHAT DRUGS ARE EXCLUDED?

• Part D Drugs/Part D Excluded Drugs [Fact Sheet]   Source: Centers for Medicare and Medicaid Services

English     

WHAT LIMITS CAN PLANS PLACE ON DRUGS INCLUDED IN THEIR PLANS?

• Drug Plan Coverage Rules    Source: Centers for Medicare and Medicaid Services

English