What Changes for Your Drug List Every Year and How to Stay Ahead

Each year, Medicare drug plans update their formularies, which can directly impact what you pay and whether your medications stay covered. Learn how to track these changes, avoid coverage surprises, and keep your prescriptions affordable with guidance from Senior Health Stop.

1. Your Medicare Drug List (Formulary) Isn’t Permanent

Many seniors assume once their medication is covered, it stays that way forever. Wrong. Medicare Part D and Advantage plans review and adjust their formularies every year, often adding or removing drugs or changing the drug tier (which affects copays).

2. Tier Changes Can Hit Your Wallet Hard

Even if your medication stays on the list, its tier placement might change. A shift from Tier 2 to Tier 3, for example, can increase your copay by 50% or more.

3. Coverage Rules May Shift Without Notice

Plans can change rules like prior authorization, step therapy, or quantity limits. These small policy tweaks can delay your prescriptions or force you to try other drugs first.

4. Switching Plans Could Save You Money

Too many seniors stay with the same plan out of habit, even when better options appear. Comparing plans annually could reduce your out-of-pocket costs significantly.

During Medicare’s Annual Enrollment Period (Oct 15 – Dec 7), compare plans using the official Medicare Plan Finder. You might find a plan that better fits your current medication list.