Category: medicare part d costs

What Are Medicare TrOOP Costs?

Keeping Track of Your Out-of-Pocket Drug Expenses

If you’re thinking about enrolling in a Medicare Part D plan, it’s likely you’ve heard the term “out-of-pocket,” which refers to the Part D expenses that aren’t reimbursed by insurance. A less familiar term, but one that is extremely important to Medicare Part D prescription drug plan members who enter the Coverage Gap, is “true out-of-pocket” or “TrOOP” costs.

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Getting to Know Your Part D Plan’s Drug List

What Medications Are Not Covered by Medicare Part D

A plan’s drug list or “formulary” is an important consideration when choosing your Part D coverage. The drug list changes each year depending on the rules and guidelines released by the Centers for Medicare & Medicaid Services (CMS) which prescription drug plans (Part D) and Medicare Advantage Plans must follow. These formulary guidelines state that plans must base their decisions on scientific evidence and well-established guidelines to cover today’s most widely used medications. This ensures that beneficiaries like you will be covered by the most commonly used and effective medications available to protect your health. (more…)

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