PassSprint

One rule, 3 ways the exam asks it. Same knowledge point, different phrasing — work through all of them, because the exam rarely reuses the wording.

Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 1/5

A Medicare Part D plan's formulary must include:

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

Why A is correct

The Centers for Medicare & Medicaid Services requires Part D formularies to include at least two drugs in each therapeutic category and class, with exceptions for certain protected classes that must include substantially all drugs. This breadth requirement ensures beneficiaries have meaningful access to treatment across disease categories while still allowing plans to manage costs through tiers and utilization controls. The formulary minimum is part of the Part D coverage rules examined under AH-III.D.1g, which also cover the coverage gap and catastrophic coverage.

Why the other options are wrong

  • B) Formularies include generics as well as brand-name drugs; generic availability helps control premiums.
  • C) No plan covers every marketed drug; formularies are managed lists of covered drugs.
  • D) The rule requires at least two drugs per class, not a maximum of one.

Memory hook

Two drugs per class is the Part D formulary floor, not a pharmacy free-for-all.

Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 2/5

Under Medicare Part D, what formulary requirement must a prescription drug plan meet?

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

Why A is correct

A Medicare Part D plan's formulary, its list of covered drugs, must include at least two drugs in each therapeutic category and class, so that beneficiaries in every drug class have real choices. Plans may structure tiers, preferred pharmacies, and prior authorization, but the formulary cannot leave an entire drug category empty. The requirement supports access to a broad range of therapies while still allowing plans to manage costs. Beneficiaries can also request formulary exceptions and must be notified when a drug they take is moved to a different tier or removed from the formulary.

Why the other options are wrong

  • B) Part D formularies must include brand and generic options; limiting a formulary to brands only would defeat cost management.
  • C) The minimum is two drugs per category and class, not five, and plans can cover many more as they choose.
  • D) Generics are the backbone of Part D formularies; excluding them would make coverage unaffordable and violate the plan's access standards.

Memory hook

Part D's rule of two: every drug class needs at least a pair of covered choices.

Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 1/5

Under Medicare Part D, what is the minimum formulary requirement for each therapeutic category and class?

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

Why A is correct

Medicare Part D plans must design their formularies to include at least two drugs in each therapeutic category and class of covered drugs. This minimum ensures beneficiaries have meaningful access to treatment options within each drug category. In addition, plans must cover substantially all drugs in the six protected classes (such as immunosuppressants, antidepressants, and antipsychotics). The two-drug minimum is a standard Part D fact tested under AH-III.D.1g, and it is the specific number the exam expects candidates to know.

Why the other options are wrong

  • B) One drug per category is below the required minimum; the standard is two drugs in each therapeutic category and class.
  • C) Five drugs per category is not the statutory minimum; the requirement is two, though plans may choose to offer more.
  • D) Part D sponsors are required to maintain formularies meeting the two-drug per category/class standard; a formulary is mandatory.

Memory hook

Two drugs per class, or the plan is out of class. Donut hole penalties needn't apply to memory here.

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