Episode
AHIP Medicare Exam Prep 23, Formularies Tiers and Utilization Management
- Podcast
- Insurance Exam Prep
- Published
- Sep 8, 2026
- Duration seconds
- 252
- Processing state
not_requested- Canonical source
- https://open-exam-prep.com/
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Summary
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