How to Find Out if a Drug Is Covered

How to Find Out if a Drug Is Covered


Hi my name is Kristen. I work here at
Tufts Health Plan Medicare Preferred, and this is the Medicare Minute. To find out if a drug is covered, look up
the name of the drug in the formulary. The formulary is a list of all the drugs
we cover. The drugs are listed alphabetically and by medical condition,
so they’re easy to find. The formulary will tell you what tier the drug is on
and if there are any special requirements. A tier is a category for
drugs. Each covered drug is on a tier, and the tier number determines the general
cost of the drug. Generally, drugs on tiers one and two are the least
expensive, while drugs on tiers three, four, and five are more expensive. The listing for the drug in the formulary will also tell you if the drug has any
special requirements. Special requirements mean you or your doctor may
need to take extra steps in order for the drug to be covered. Some drugs have a special requirement
that you try a different drug first, while some have a limit on the amount
you can fill at one time. A drug may have a special requirement for safety, quality,
or cost reasons, but not every drug has a special requirement. The easiest way to look up a drug is by
using the online formulary on our website. If you have any questions, you
can always give us a call. We hope you found this helpful.
Thanks for watching this edition of the Medicare Minute.

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