Why so many Medicare beneficiaries have trouble getting their Part D plan to cover their medications—and how to prevent it from happening to you

Fortune April 8, 2024
Richard Eisenberg

If you have a Medicare Part D prescription drug plan and take one or more brand-name medications—especially, expensive ones—there’s a very good chance you’ll run into trouble getting it covered.

Even worse, according to two recent studies, the possibility of being told by the plan that you either can’t get an expensive brand-name drug because it’s not on its “formulary” list or will need prior authorization has grown significantly.

And that can be bad for your health, considering that people with Medicare Part D plans take an average of four or five prescription drugs a month.

Branded medications often have Medicare restrictions

“When you’re talking about branded products, almost seven out of 10 have either some restriction or they’re...

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