I'm getting conflicting information about whether Medicare covers my specific medication. How can I get a definitive answer?

Question

Melonie Wood · Accepted Answer

This is why it is so important to actually meet with an agent in person who has several carriers they write for. The agent can put the members in the carrier's formulary to make sure the medication is covered

Answered by Melonie Wood on April 4, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent

Clarence &quot;Mark&quot; Christiansen · Answer

Go to this public web site: medicare.gov, click "Find a Plan Now" then key in your zip code and medications. Follow the prompts.

Dana Dane · Answer

Please contact your insurance agent for assistance.  If you don't have an agent, please contact your prescription insurance company.

Tasha Riggs · Answer

It will depend on your plan that you pick. The cost and coverage will be different based on the Drug card you buy or the Medicare Advantage plan you buy.

Aaron Solomon · Answer

There are 2 ways. You can work with an agent. He can look up all your drugs. He can look at each companies formulary. The second option is to look it up on the Medicare site

Mal Varlack · Answer

Each Medicare Plan has a “formulary”, which is a document that states which medications are covered in part or fully by that particular plan. You can either call Member services on the back of the card and speak to a representative or call your broker who can also look up your plan and give you the answer as you both go over your medications.

Answered by Mal Varlack on April 17, 2025

Agent Licensed in FL

Answered by Mal Varlack Medicare Insurance Agent

Gary Henderson · Answer

Sign onto medicare.gov follow the steps for prescription drug plans. Enter in the medication you're taking and it will tell you what the coverage is for that particular medication 
There are many Medicare plans for prescriptions out there. Most of them will cover the majority of drugs 
There's also a annual $2,000 limit now out of pocket so you cannot exceed that with any company that you work with

Betty McCarty · Answer

This depends on the type of Medicare drug plan you have. All Medicare drug plans have a formulary. A Medicare formulary is essentially a list of prescription drugs that a Medicare drug plan covers. Contact your Medicare Plan provider and request a drug formulary. I will be happy to assist you if you have more questions.

Answered by Betty McCarty on April 5, 2025

Agent Licensed in WA

Answered by Betty McCarty Medicare Insurance Agent

Brianna Douros · Answer

How are you getting conflicting information? From your agent? From a website? I would call the specific company you are planning to go with so they can clarify.

I'm getting conflicting information about whether Medicare covers my specific medication. How can I get a definitive answer?

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I'm getting conflicting information about whether Medicare covers my specific medication. How can I get a definitive answer?

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Agent Locator

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A non-government resource website