Urgently needed care

Urgently needed care is the type of care that people get outside of the Medicare health plan’s Service area for a sudden injury illness that requires immediate medical care but isn’t life threatening. If it’s unsafe to wait until you get home to get care from your plan doctor, the health plan must pay for…


Tiers are groups of drugs that have a different cost for each tiered group. Usually, a drug in a lower tier will be less expensive compared to a drug that’s in a higher tier.


A Supplier is typically any person, agency, or company that provides you a service or medical item, except for when you’re an inpatient in a Skilled nursing facility or hospital.

Step therapy

Step therapy is defined as a coverage rule used by some Medicare Prescription Drug Plans. They require you to try 1 or more similar, but lower priced drugs to treat your health condition before the plan will cover the prescribed drug.