Direct answer: Look up each prescription on the plan's formulary for the correct plan year. Confirm the drug name, strength, quantity, and your pharmacy. Watch for prior authorization, step therapy, quantity limits, and specialty tiers. HealthCare.gov explains how Marketplace plans cover medications. Medicare drug plans use plan finders and formularies on Medicare.gov. Do not rely on last year's list.
What is a formulary?
A formulary is the plan's list of covered drugs and the rules attached to them. Tiers affect copays. Prior authorization means the plan must approve the drug before it pays. Step therapy can require trying another drug first. Quantity limits cap how much you can fill. These rules are in the plan documents, not in a metal name or a Medicare marketing flyer.
How do I check a Marketplace or employer plan?
HealthCare.gov prescription guidance is the Marketplace starting point. Search the exact plan ID. If you use a specialty pharmacy, confirm that pharmacy is in network. If you are comparing metal levels, a Gold plan can still exclude or restrict a drug that a Silver plan covers. See Bronze vs Silver vs Gold and the annual checklist at the prescription-cost checklist. This page is the method; that checklist is the annual reminder.
How do I check Medicare drug coverage?
Use the Medicare plan tools on Medicare.gov with your drug list and pharmacy. Advantage formularies and stand-alone Part D formularies are different products. Coverage varies by plan. If you change from Advantage back to Original Medicare, you must check the new Part D formulary. See returning to Original Medicare.
What details should I bring to a review?
Drug name, dose, how often you fill, and preferred pharmacy. Include inhalers, insulin, injectables, and mental-health medications. Use the provider and prescription check so those fields are complete. David Huff, a licensed Florida health agent, can help you compare formularies. A directory or formulary search can differ from what the pharmacy charges at fill time.
What if the drug is covered but the pharmacy is not?
Preferred pharmacies, mail-order rules, and 90-day supplies can change what you pay even when the drug is on the formulary. A drug listed as covered can still require a specialty pharmacy. Confirm the fill location, not only the name of the medication.
If you use insulin, inhalers, or injectables, include devices and test supplies on the same list. Plans often treat those items under separate rules. Medicare drug coverage and Marketplace coverage both need that level of detail.
Save a screenshot or PDF of the formulary result with the plan year visible. If the list changes after you enroll, you have a baseline for a coverage exception request.
How do Medicare and Marketplace checks differ?
Marketplace formularies live on HealthCare.gov and issuer sites for that plan year. Medicare drug lists live on Medicare.gov plan finders and issuer sites. The idea is the same: search the exact plan ID, year, drug, dose, and pharmacy. Do not reuse last year's screenshot.
Medicare Advantage plans that include drugs still need the same check. A medical network match does not prove a formulary match. See the prescription-cost checklist for an annual review worksheet, and use this page for the method.
Bring the list to a licensed Florida health agent review. Call (863) 640-3102 or use Get Help.
What to do next
Print or save the formulary result for each drug on each plan ID you might choose, including dose, quantity limit, and pharmacy. Then enroll only after the list matches care you already use. Call (863) 640-3102 or use Get Help.
Check the formulary before you pick the plan
Bring every prescription and pharmacy. Formulary searches are plan-year specific and can change.
Request a Plan Review Call (863) 640-3102Sources
Formularies, tiers, restrictions, pharmacies, and costs are subject to the applicable plan documents and can change. Confirm with the plan and the pharmacy before you enroll.
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 73 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Company inventory note: The 10 organizations and 73 products referenced above reflect the plans available for the 2026 plan year in the Lakeland/Polk County service area as of August 17, 2026. They are not CMS counts or statewide Florida totals. Counts and available products vary by ZIP code, service area, plan year, and current company authorization. Confirm the ZIP code and current approved platform inventory before relying on these figures. Plan availability, benefits, networks, formularies, pharmacies, and costs are subject to the applicable plan documents and service area.