How do I find out whether my Medicare drug plan has a low-costing Tier One or Two medication that would substitute for my Tier Three prescription?
You and/or your prescriber can use our online Formulary Browser (
FormularyBrowser.com) to check your Medicare Part D (PDP) or Medicare Advantage (MAPD) plan's drug list (formulary) for lower-costing drug alternatives. Our formulary browser shows each medication, its drug tier, cost-sharing, and drug usage management restrictions.
Alternatively, you can call your Medicare plan's Member Services
department and ask whether the plan covers any lower-costing alternative
drugs to what you currently using. The toll-free number for Member
Services is printed on your Member ID card and most of your plan
information that you have already received.
You can also telephone a Medicare representative at 1-800-633-4227 and
ask whether your Medicare plan covers any of the generic alternatives to
your brand name medication.
Likewise, you can perform the same search using the Medicare.gov Plan
Finder and when you are asked to enter your brand-name drugs, you also
should have the choice of selecting the generic alternatives. When you
move to the step after selecting your pharmacies, you can see if your
Medicare plan is one that covers the generic alternatives.