AHIP Medicare Exam Prep 23, Formularies Tiers and Utilization Management

This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams.

In this episode you will learn:

- How Medicare Part D plans structure formularies into drug tiers from Tier 1 generics to Tier 5 specialty drugs

- Why cross-referencing both specific medications and preferred network pharmacies is essential for accurate cost estimates

- The mechanics of utilization management tools including prior authorization, step therapy, and quantity limits

- Rules surrounding mid-year formulary changes, sixty-day advance notices, and immediate FDA safety exceptions

- The PSL mental shortcut to quickly identify Part D coverage restrictions on exam questions

For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep