Question

What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications?

Choose one answer.
a. Part D plans may use varying co-payments for brand name and generic drugs, but they may not restrict access through prior authorization.
b. The Federal government establishes a set formulary, or list of covered drugs, each year that the Part D plans must use. Beneficiaries should consult the government's list prior to deciding whether they wish to enroll in a Part D plan during that year.
c. Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered co-payments and prior authorization.
d. Part D plans may use varying co-payments, but they are required to cover all prescription medications on the market.

Answer 1

Medicare Part D plans have flexibility in managing how enrollees access medications; they do not have to cover all medications and can use tiered co-payments and prior authorization among other cost containment strategies.

Step-by-step explanation:

The correct answer to the question about the types of tools that Medicare Part D prescription drug plans can use to affect how enrollees access medications is: c. Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered co-payments and prior authorization.

It's important to understand that while Medicare Part D has significantly improved access to prescription drugs for the elderly and disabled, the plans vary and may employ different strategies to manage costs. This includes not covering certain drugs, utilizing a formulary that lists which medications are covered, and implementing cost-sharing methods to influence drug choices and usage.