Can my drug plan make me try a different medication before covering the one my doctor prescribed?

Yes. What you’re describing is called step therapy (ST), a tool used by most Medicare drug plans. The plan may require you to first try a less expensive drug that treats the same condition. If that drug doesn’t work for you, the plan may agree to cover the originally prescribed (more expensive) one. To request an exception to the ST process, your doctor must contact the plan and explain why the lower-cost alternative is not appropriate for you and why the higher-cost medication should be the first course of treatment. If the plan agrees, it will cover the medicine your doctor prescribed. If the plan says no, you can use the plan’s appeal process to request a decision review.

My wife and I have Medigap and Part D plans. If we move to another state, will our Medicare coverage change?

Your Medicare Parts A and B (hospital and medical coverage) will stay the same when you move to another state.

Your Medigap plan is standardized and portable across most of the country. (Three states—Minnesota, Massachusetts and Wisconsin—have their own plans.) Your monthly cost will change to that of your new state.

Your drug plan will not move with you. You’ll have a two-month special enrollment period to switch plans after you move. The same rule applies if you have a Medicare Advantage plan.