What limitation do Medicare Part D plans have regarding the medications they cover?

Medicare Part D plans are required to develop formularies, which are lists of covered drugs. These formularies can include a range of medications but do not have to cover every medication available. Instead, they can utilize cost-containment techniques, which allows them to manage the costs associated with prescription drugs. This means that Part D plans can have varying levels of coverage for different medications, and some drugs may be excluded from coverage altogether based on factors such as their cost or the availability of alternatives.

The ability to employ cost-containment strategies helps ensure that plans can offer affordable and sustainable coverage to beneficiaries while still providing access to a wide array of medications. This flexibility is essential for balancing the needs of patients and the financial viability of the plans.