After the links just below to introductory materials and the CMS "Formulary Finder" tool, there are additional, more detailed materials explaining WHAT DRUGS ARE COVERED, WHAT DRUGS ARE EXCLUDED, and WHAT LIMITS PLANS CAN PLACE ON DRUGS INCLUDED IN THEIR PLANS.

• Medicare Q&A Weekly Column on Drug Coverage, Limits, and Appeals [Fact Sheet]   Source: Kaiser Family Foundation

English     

A brief description of questions to ask about what drugs are included in a plan, how much they will cost, and what the limits or restrictions are.

• Formulary Finder for Prescription Drug Plans [Interactive Tool]   Source: CMS

English     Spanish     

This tool can help find plans in your state that match your required drug list. For each plan, the tool can then tell you what forumualry tier each of the drugs is in and what limits or restrictions, if any, the plan has on getting access to each of the drugs.

WHAT DRUGS ARE COVERED?

• Getting Medicare to Cover Your Drugs: Parts A, B or D? [Fact Sheet/PDF]   Source: Medicare Rights Center

English     

• Tip Sheet: Medicare Drug Coverage under Medicare Part A, Part B, And Part D   Source: CMS

English     

Explains what drugs are and are not covered under these parts of the Medicare program.

• A Guide to Medicare Part D for Prescription Drug Coverage for People with Developmental Disabilities: Drug Formularies [Fact Sheet]   Source: Disability Policy Collaboration

English     

Includes good basic information about what drugs will be covered and how drug formularies will work, as well as specific information for individuals eligible for both Medicare and Medicaid (dual eligible individuals).

WHAT DRUGS ARE EXCLUDED?

• A Guide to Medicare Part D for Prescription Drug Coverage for People with Developmental Disabilities: Excluded Medications [Fact Sheet]   Source: Disability Policy Collaboration

English     

Includes good basic information about what drugs will be excluded from prescription drug plans, as well as specific information for individuals eligible for both Medicare and Medicaid (dual eligible individuals).

WHAT LIMITS CAN PLANS PLACE ON DRUGS INCLUDED IN THEIR PLANS?

• A Guide to Medicare Part D for Prescription Drug Coverage for People with Developmental Disabilities: Other Limits on Access to Medications [Fact Sheet]   Source: Disability Policy Collaboration

English     

Includes good basic information about limits prescription drug plans can place on access to drugs.