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Trends in Dual-Eligible Enrollees’ Access to Drugs Under Part D, 2011–2025

Announced on  | Last Modified on  | Project Number: OEI-05-25-00350
Status
Completed
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

Dual-eligible enrollees—that is, people enrolled in both Medicare and Medicaid—have received prescription drug coverage under Medicare Part D since 2006. As long as Part D plans meet certain limitations outlined in 42 CFR § 423.120, Part D sponsors have discretion to include different drugs in their formularies. This work will report trends in the extent to which formularies used by Part D plans included drugs commonly used by dual-eligible enrollees, which OIG has analyzed annually as required by law, from 2011 to 2025.

TIMELINE

  • July 15, 2025
    Announced
  • December 12, 2025
    Complete

    Trends in Dual-Eligible Enrollees’ Access to Drugs Under Part D, 2011–2025 has been marked as complete. Report Published

REPORT PUBLISHED

Trends in Dual-Eligible Enrollees’ Access to Drugs Under Part D, 2011-2025 (OEI-05-25-00350)

  • Most Part D plan formularies have covered almost all of the drugs that dual-eligible enrollees commonly use since 2011, and coverage has been consistently high over the last decade.
No recommendations were issued as a part of this report.
Work Plan Type
Office of Evaluation and Inspections
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Prescription Drug
Target Groups
-
Financial Groups
Medicare D