Frequently Asked Questions about Coverage of Specific Drugs

Nov, 13 2022 — Yes.  Medicare Part D prescription drug plans do cover the shingles vaccine (stand-alone Medicare Part D plans and Medicare Advantage plans that include drug coverage).  However, coverage (a . . .

Nov, 13 2022 — Although Ambien, was covered by many Medicare Part D carriers in prior years, it is currently covered by only a few Medicare Advantage plans (MAPD) and no prescription drug plans (PDP). Instead . . .

Jan, 18 2023 — Yes.  In 2023, the Inflation Reduction Act (IRA) of 2022 introduces a provision similar to the 2021-2022 Senior Savings Model with insulin provided at a $35 30-day co-pay throughout all phases . . .

Jan, 21 2023 — A few 2023 Medicare Advantage plans cover Fioricet with Codeine and Fioricet without Codeine, however no stand-alone Medicare Part D plans cover Fioricet with or without Codeine. For example, the 2 . . .

Jan, 10 2022 — Maybe.  Depending on the ingredients of the compounded drug there may be at least partial brand-name or generic drug coverage.  For more information about coverage of compounded drugs, plea . . .

Mar, 13 2022 — Yes, the cost-sharing for any Medicare Part D prescription drug might vary depending on the chosen Medicare prescription drug plan and pharmacy. For example, if we are looking at stand-alone 2015 M . . .

Sep, 06 2022 — Yes, "when [these medications are] used to treat epilepsy, cancer, or a chronic mental health disorder". A certain group of prescription medications are specifically excluded from Medicare Part D p . . .

Jan, 27 2023 — All Insulin products covered by your Medicare Part D drug plan will cost $35 or less for a 30-day supply.In 2023, the Inflation Reduction Act (IRA) introduces an insulin cost-saving provision - simil . . .

Jan, 23 2023 — Starting back in 2019, your Medicare Part D plan (MAPD or PDP) implemented a drug management program (or drug utilization management) to monitor and limit "at-risk" Medicare beneficiaries’ acces . . .

May, 20 2022 — Niaspan® is no longer covered by many Medicare Part D prescription drug plans. To see the which Medicare prescription drug plans in your area that are now covering Niaspan, you can use our Dru . . .

Aug, 28 2022 — No. The 75% Donut Hole discount, does not apply to Medicare Part D excluded drugs even if they are covered by the Medicare Part D prescription drug plan as a “Bonus Drug” (also known as &# . . .

Aug, 28 2022 — Bonus or Supplemental drugs are medications specifically excluded from the Medicare Part D program - although they are covered by your Medicare drug plan (as a "bonus").Since these drugs are not cover . . .

Aug, 16 2022 — No.  Medicare changed positions on this policy and first provided Donut Hole discounts for compounded Medicare Part D drugs in May 2010: "Part D sponsors shall only provide a discount on a compo . . .

Aug, 28 2022 — The Centers for Medicare and Medicaid Service (CMS) defines a Medicare Part D covered drug as:"A Part D covered drug is available only by prescription, approved by the FDA (or is a drug described unde . . .

Jul, 26 2019 — As noted by the United States Food and Drug Administration (FDA): "The term “authorized generic” drug is most commonly used to describe an approved, brand name drug that is marketed a . . .

Jan, 27 2023 — All Insulin products covered by your Medicare Part D drug plan will cost $35 or less for a 30-day supply.In 2023, the Inflation Reduction Act (IRA) introduces an insulin cost-saving provision - simil . . .

Jan, 23 2023 — Starting back in 2019, your Medicare Part D plan (MAPD or PDP) implemented a drug management program (or drug utilization management) to monitor and limit "at-risk" Medicare beneficiaries’ acces . . .

Jan, 21 2023 — A few 2023 Medicare Advantage plans cover Fioricet with Codeine and Fioricet without Codeine, however no stand-alone Medicare Part D plans cover Fioricet with or without Codeine. For example, the 2 . . .

Jan, 18 2023 — Yes.  In 2023, the Inflation Reduction Act (IRA) of 2022 introduces a provision similar to the 2021-2022 Senior Savings Model with insulin provided at a $35 30-day co-pay throughout all phases . . .

Nov, 13 2022 — Although Ambien, was covered by many Medicare Part D carriers in prior years, it is currently covered by only a few Medicare Advantage plans (MAPD) and no prescription drug plans (PDP). Instead . . .

Nov, 13 2022 — Yes.  Medicare Part D prescription drug plans do cover the shingles vaccine (stand-alone Medicare Part D plans and Medicare Advantage plans that include drug coverage).  However, coverage (a . . .

Sep, 06 2022 — Yes, "when [these medications are] used to treat epilepsy, cancer, or a chronic mental health disorder". A certain group of prescription medications are specifically excluded from Medicare Part D p . . .

Aug, 28 2022 — No. The 75% Donut Hole discount, does not apply to Medicare Part D excluded drugs even if they are covered by the Medicare Part D prescription drug plan as a “Bonus Drug” (also known as &# . . .

Aug, 28 2022 — Bonus or Supplemental drugs are medications specifically excluded from the Medicare Part D program - although they are covered by your Medicare drug plan (as a "bonus").Since these drugs are not cover . . .

Aug, 28 2022 — The Centers for Medicare and Medicaid Service (CMS) defines a Medicare Part D covered drug as:"A Part D covered drug is available only by prescription, approved by the FDA (or is a drug described unde . . .

Aug, 16 2022 — No.  Medicare changed positions on this policy and first provided Donut Hole discounts for compounded Medicare Part D drugs in May 2010: "Part D sponsors shall only provide a discount on a compo . . .

May, 20 2022 — Niaspan® is no longer covered by many Medicare Part D prescription drug plans. To see the which Medicare prescription drug plans in your area that are now covering Niaspan, you can use our Dru . . .

Mar, 13 2022 — Yes, the cost-sharing for any Medicare Part D prescription drug might vary depending on the chosen Medicare prescription drug plan and pharmacy. For example, if we are looking at stand-alone 2015 M . . .

Jan, 10 2022 — Maybe.  Depending on the ingredients of the compounded drug there may be at least partial brand-name or generic drug coverage.  For more information about coverage of compounded drugs, plea . . .

Jul, 26 2019 — As noted by the United States Food and Drug Administration (FDA): "The term “authorized generic” drug is most commonly used to describe an approved, brand name drug that is marketed a . . .