Can Mr. Wingate's non-formulary medications count toward TrOOP for his Part D coverage?

TrOOP, or True Out-of-Pocket costs, refers to the money that a beneficiary spends out of their own pocket for covered Part D drugs, which helps determine when they will enter the catastrophic coverage phase of their plan. For a medication to count toward TrOOP, it must be a covered drug under the beneficiary's Part D plan's formulary.

Non-formulary medications are those that are not included on a plan’s list of covered drugs. Since these medications are not recognized as covered drugs by the plan, any costs associated with them cannot be counted toward the beneficiary's TrOOP. Therefore, when Mr. Wingate purchases non-formulary medications, those costs will not accumulate toward the out-of-pocket threshold that triggers the transition to catastrophic coverage, making this the correct rationale behind the answer that none of his non-formulary medications currently count toward TrOOP.

Options suggesting that non-formulary medications could count under certain conditions or other types of medications disregards the fundamental rule that non-formulary drugs simply do not qualify for TrOOP calculations.