Q: Why does my plan require prior authorization for some drugs?
A: Prior authorization ensures that certain medications are medically necessary or used correctly. Your doctor will submit documentation to approve the prescription.
Q: Can I use GoodRx with Medicare Part D?
A: Yes, but not together. You can choose to use a GoodRx discount instead of your Part D plan for a specific prescription, but that purchase won’t count toward your plan’s out-of-pocket total.
Q: What is a drug formulary?
A: It’s your plan’s official list of covered drugs. Formularies are organized into tiers, and each tier has different copay amounts.
Q: Why do my prescription costs change during the year?
A: Part D has four phases: deductible, initial coverage, donut hole, and catastrophic coverage. As your yearly drug spending increases, you move through these phases and your costs adjust.
Q: Do I need Part D if I don’t take any medications?
A: Yes, most people should still enroll. If you don’t, you’ll pay a lifetime penalty when you eventually need drug coverage—plus you won’t be protected if a new medication becomes necessary.