This section will explain the terms you will need to know to compare Medicare Prescription Drug Plans. When you are ready, you will use the Medicare.gov Plan Finder to compare specific plans.
In this section:
- What is a drug list or formulary?
- What are payment tiers? (Learn about different co-pays for generic and brand name drugs.)
- What special rules or limits might I need to know? (Learn about prior authorization, step therapy, and limits on quantity.)
- What can I do if my drug is not covered on my plan’s drug list?
- Which drugs must all plans cover?
- Which drugs do all plans exclude by law?
- Will the injections or shots I get at my doctor’s office be covered?
- What should I know about my access to pharmacies?