Medicare.gov - MOC: Supporting Information

Glossary

Term	Definition
Tiers	Drugs on a formulary are often organized into different drug "tiers," or groups of different drug types. Your cost depends on which drug tier your drug is in. For example, a plan may form tiers this way: Tier 1 - Generic drugs. Tier 2 - Preferred brand-name drugs. Tier 3- Non-preferred brand name drugs. Contact the plan to learn more about its specific tier structure.
Timely Appeals Decision	An appeals decision is considered to be timely when it meets Medicare's appeals timeframes. The specific timeframe depends on the type of appeal, and ranges from 24 hours to 7 days. Refer to your drug plan's explanation of coverage for more details about the appeals process.

Term

Definition

Drugs on a formulary are often organized into different drug "tiers," or groups of different drug types. Your cost depends on which drug tier your drug is in.

For example, a plan may form tiers this way:

Tier 1 - Generic drugs.
Tier 2 - Preferred brand-name drugs.
Tier 3- Non-preferred brand name drugs.

Contact the plan to learn more about its specific tier structure.

Timely Appeals Decision

An appeals decision is considered to be timely when it meets Medicare's appeals timeframes. The specific timeframe depends on the type of appeal, and ranges from 24 hours to 7 days. Refer to your drug plan's explanation of coverage for more details about the appeals process.

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations,and rulings.