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Medicare Part D: What Drugs Are Covered - The Formulary


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Medicare Part D provides insurance for drugs you purchase at the pharmacy or through mail order.

Part D plans generally only cover drugs listed on the Plan's Formulary which are purchased at a pharmacy in the Plan's network.

Plans must include an exception for drugs which are not excluded by law if:

  • Your doctor feels the drug is the only drug that will work for you.
  • You take the drug at the time when you sign up for a plan.

You can also request an Exception to get a lower copayment for a drug that is already included in your plan's formulary.

Part D Plans do not cover drugs received in a hospital as an in-patient, or drugs given to you in a doctor's office through a medical professional. These drugs are covered by Medicare Part A and Part B, respectively.

Part D does cover drugs received in an assisted living facility or nursing home.

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