Which prescriptions will Medicare Part D cover?

1 answer | Last updated: Oct 12, 2016
A fellow caregiver asked...

Where can I find out which prescriptions Medicare D will cover? If Medicare part D covers only part of the cost of the medicine, will Medicaid pick up the difference ? I'm interested in this information for a Nevada resident. Thanks.

Expert Answers

The specific prescription drugs a Medicare Part D plan covers depends entirely on the particular plan you enroll in (though every plan must cover at least one drug in all major therapeutic categories). Medicare's official Web site provides a simple tool called the Formulary Finder in which you just enter your zip code and it provides you with contact information on all the Medicare Part D prescription drug plans being sold where you live, and the specific drugs that is on each plan's "formulary" (its list of covered drugs).

Whether a particular Medicare Part D drug plan includes in its formulary the medicines you take should be only the beginning of your search for information. Next, you should directly contact any plan you are considering to find out if the plan places any restrictions on any of your drugs. Some restrictions have to do with cost, some with what version of the drug you can get, and some with how easily you have access to the drugs, regardless of your doctor's prescription.

If you are also eligible for Medicaid, Medicaid will cover the monthly premium for your drug plan and most of the cost of any deductible and copayments. However, if you want Medicaid to provide this coverage, you may only enroll in one of the Medicare part D plans that charge a monthly premium at or less than the average in the state where you live. To find out which plans are covered by Medicaid, contact Nevada's central Medicaid office or a local Medicaid office near you.