Drug Formulary Official Definition: “CMS defines a Drug Formulary as a list of certain drugs and their proper dosages. In some Medicare health plans, doctors must order or use only drugs listed on the health plan’s formulary.” –...
Creditable Prescription Drug Coverage Official Definition: “CMS defines Creditable Prescription Drug Coverage as prescription drug coverage (for example, from an employer or union) that’s expected to pay, on average, at least as much as...
Coverage Gap Official Definition: “CMS explains that once you reach the coverage gap, you’ll pay no more than 25% of the cost for your plan’s covered brand-name prescription drugs. You’ll pay this discounted rate if you buy your...
Medicare Part D Official Definition: “CMS defines Medicare Drug Coverage and Plan Part D as Optional benefits for prescription drugs available to all people with Medicare for an additional charge. This coverage is offered by insurance companies and...
Maximum Out-of-Pocket Official Definition: “CMS defines the Maximum Out-of-pocket as the beneficiary’s maximum dollar liability amount for a specified period.” – www.medicare.gov [Medi-Care-Eez] Definition: “…with...
Annual Election Period Official Definition: “CMS defines Medicare’s annual Open Enrollment Period (October 15–December 7) as a period to join a plan. During this time each year, you can also drop or switch your plan coverage.” –...