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Part D formularies change, and tiers drive your cost

Part D plans use formularies (covered-drug lists), tiers, and rules like prior authorization, quantity limits, and step therapy. Formularies and costs can change from year to year—even if your health stays the same.

Why it Matters

Your medication costs can jump unexpectedly if a drug changes tier, requires approval, or is removed from the formulary.

Action Steps
  • Check that each medication is on your plan’s formulary. 

  • Ask about lower-cost alternatives if a drug is high tier.

  • Review drug coverage during the annual enrollment period.

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Medicare for Men is not affiliated with or endorsed by the U.S. government, Medicare, CMS, or HHS.
Educational only — not medical, legal, or financial advice, and not a guarantee of coverage. For guidance, see Medicare.gov/SHIP, your plan documents, and your doctor.
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