Medicare Part D: Track formularies, monitor patient compliance – and prepare to appeal

Article Overview

This article discusses Medicare Part D from a practice-management perspective, focusing on prescription drug coverage for Medicare patients, plan formularies, affordability concerns, and the steps involved when coverage decisions need to be challenged. It is relevant to interventionalists, physicians managing long-term medication therapy, and staff who help patients understand coverage and access issues. The guidance is framed around monitoring coverage changes, understanding general patient responsibility under Part D, and recognizing the existence of formulary exceptions and appeals timelines.