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Questions with the Keyword MEDICATION / MEDICINE / DRUGS
| Questions | Possible Answers |
|---|---|
| Does the [plan name] plan cover [medication name]? If yes, under what tier? | Yes, [medication name] is covered as a Tier 3 medication. |
| My aunt uses [medication name]. Is that on your formulary? | No, [medication name] is not covered. |
| Does the Acme Medicare Rx plan require a prior authorization (PA) for [medication name]? | No, a PA is not required for [medication name]. |
| Does the Acme Medicare Rx plan cover [medication name]? | Only the Acme Xtra and Acme Max plans cover [medication name]. This medication is not covered under the Secure plan. |
| My mother uses [medication name]. Is it on your formulary? | Yes, [medication name] is covered. |
| My mom wants to get a preventive tetanus shot. She has not been injured. Is a preventive tetanus shot covered by Part D? | Yes, preventive tetanus shots are covered under Part D. |
| Is [medication name] covered on the 2023 Acme Medicare Rx plan formulary? | Yes, [medication name] is covered under all three Acme Medicare Rx plans. |
| Does Acme Medicare Rx plan cover [medication name] [dosage] tablets? | No, Acme Medicare Rx plan does not cover [medication name] [dosage] tablets. |
| If my mom joins your plan, and one of her medications is not covered by your plan, can she at least get a one-time, temporary supply of her medicine within the first 90 days of her enrollment in the plan? | Yes, all new members are eligible for transitional benefits during the first 90 days in our plan, where they are able to fill Medicare Part D approved prescriptions not on the formulary. |
| For Acme Medicare Rx, what is the maximum cost share for a one-month supply of a Tier 1: Preferred generic drug at an in-network pharmacy? | For a Tier 1: Preferred generic drug, the copay is $10 at our network pharmacy and $0 at our preferred pharmacy on all three plans. |
| If a doctor prescribes a brand-name drug that is covered by your plan, how much of a discount will there be while in the coverage gap? | When reaching the coverage gap, you will pay 47.5% coinsurance for brand-name medication and 72% towards generic medications. |
| If my doctor wants me to try out a new medication for just a few days, would I have to pay the copay for a full month’s supply? | No. |
| How much will it cost if I purchase a one-month supply of the medication Humalog, which is a preferred injection medication, in a standard retail pharmacy? | That one has a $47.00 copay. |