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Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5

Medicare Part D prescription drug plans will pay for a drug only if it is:

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

A Part D plan covers drugs that appear on its formulary, the approved list of covered drugs. Formularies must include at least two drugs in each treatment category but are not required to include every drug on the market, so a prescribed drug is covered only if the plan has placed it on the formulary. The formulary requirement and its tiers are expressly covered in the Part D material under AH-III.D.1g of the examination objectives, and the enrollee must verify coverage before relying on the plan to pay.

Why the other options are wrong

  • B) Coverage depends on the plan formulary, not on where the prescriber is licensed.
  • C) Part D and Part B cover different categories of drugs; a drug being covered under Part B does not make it a Part D formulary drug.
  • D) Only pharmacies in the plan's network and drugs on the formulary are covered, not any retail store.

Memory hook

If it's not on the formulary, Part D won't pay.

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