Each Medicare drug plan will have a list of prescription drugs that it covers. Plans cover both generic and brand-name prescription drugs. The drug lists must include a range of drugs in the most commonly prescribed categories and classes. This makes sure that people with different medical conditions can get the treatment they need. The prescription drug list may not include your specific drug. However, in most cases, a similar drug should be available. If you or your doctors don’t believe any of the drugs on your plan’s drug list are appropriate, you can ask for an exception.
If a plan removes a drug you are taking from their drug list, your plan must notify you at least 60 days in advance. You may have to change the drug you use or pay more for it or file an exception. In most cases, if you are actively taking a drug on their drug list during the calendar year, you will be permitted to continue taking the drug until the end of the year.
Using drugs on your plan’s list will generally save you money. Using generics instead of brand-name drugs can also save you money.
