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Compare Medicare Part D – Five Things To Consider

Don’t compare Medicare Part D plans without considering these 5 thingsColorful Good Better Best Street Sign

To compare Medicare Part D plans you must understand all the moving parts. And there are a lot of moving parts.

Often people choose a plan based on a narrow set of criteria only to find that the plan did not meet their needs or ultimately had a much higher cost than they originally thought.

Choosing the right Medicare prescription drug plan is critically important. The time frame in which you can join or switch plans is short and one wrong calculation can have you locked into the wrong plan for a full year.

Ignore these five things and choose the wrong Part D plan

1. Before you even think about the monthly premium look at he plan’s forumulary or list of covered medications. If your drugs are not covered by the plan the best price makes no difference.

This is not the time to try to save a couple dollars as it may end up costing you a lot more if you have to pay out-of-pocket for drugs that are not covered.

The Part D formulary is the most important piece of information when you are comparing plans. Be aware that some plans include a basic formulary and others offer an expanded formulary that will cover more specialty drugs.

2. Of course the monthly premium is important but find plans that include your drugs first and then compare price. If your income is limited check to see if your are eligible for extra help with your Part D costs.

3. Comparing Part D premiums is easy but determining the total cost of using a plan requires a little more effort. The good news is that the initial Part D coverage limit, out-of-pocket threshold amount and donut hole are standardized and will be the same on all plans.

The part that gets tricky is deciphering the costs of using your plan. These costs include co-payments, coinsurance and the possibility of an annual deductible that can be as high as $325 for 2013 plans. For example, if you require even a below average amount of medications you should divide the deductible by 12 months and add that to your premium.

Another cost to consider is the tier placement of a drug. Some plans may place a drug in tier 2 while others may place the same drug in tier 3. This is why reviewing the formulary is so important.

4. Take into consideration your network of pharmacies and if you will receive a lower copay for using certain brand pharmacies or be penalized if you do not.


 

For example, the Humana Walmart Preferred Rx plan will require higher co-pays at non-preferred pharmacies. If you only use Walmart, Sam’s Club or Neighborhood Markets to fill your

prescriptions you may come out ahead.

The same can hold true for filling your prescriptions at CVS for CVS Caremark Part D plans.

5. Review the benefits of using the mail order option for each plan you are considering. Some Part D plans will fill tier 1 drugs without a co-pay while other will charge you a reduced amount. If you require several maintenance medications this can add up over the course of the year.

When taking these 5 things into consideration you can easily compare Medicare Part D plans and find the best plan for your circumstances. Shop online or visit the Medicare website to learn more.

7 comments

  1. I can’t help but wonder how in the world how people in their
    80s or 90s can be expected to wade through a big book to try
    to figure out what they should subscribe to, I am 90 and most of us at this age are not mentally alert at this age I have a friend who is a paralegal working with the disabled, she looked through the book and shook her head, I pay a high
    premium for AARP which I have had for years and Bravo and Epic are for my meds, some $400 a month, my medical is high but I don’t qualify as I am over by a small amount to receive extra benefits,boy does our country need Fixing!!
    sincerely ginny ogden

  2. I dont under stand my ins come who I love is still going to charge me 40.00 for outpatient mental health, when the 2013 medicare and you book says I would only pay 35% of the allowed amount. The 40.00 is considerably higher is this legal.. would like an answer either email on on here. thanks

  3. Ginny, You’re not alone, many people have left similar comments. Try to find a trusted advisor who can help you navigate through your choices.

  4. I doubt I qualify for SNP but what agency has a listing for trusted advisers in Arizona? The one I have is kind of a flake & does not follow up on other questions. Is there such a thing because right now it just a guessing game & Google searches.

    I called state medicare ( I think) & had plans sent but the person there only knew one she dealt with some time back.

    Thanks

  5. Rod, You might try speaking with someone from your local Area Council on Aging. You should get unbiased information and not someone chasing a commission.

  6. Hi David I am 64 ..soon to be 65 in Feb….I take no essential prescriptions .I have no health problems ,I do take ambien off & on/nexium…Am I already signed up with Medicare if they sent me a card..Do I only need part D…thanks for your advise..

  7. Ann, If you do not sign up for Part D when eligible, but decide (or need) to sign up later, you will pay a late enrollment penalty every month for as long as you have Part D. This could add up to a lot of money! Also, remember it’s insurance. You hope you never need it but it is generally smart to have. As an example; I have homeowners insurance and have never filed a claim, but most people would think it prudent that I have the coverage.

    Many people who have little need for prescription drugs sign up for a plan with a low monthly premium. Here are Part D plans listed by State.

    Yes you are signed up with Medicare Parts A and B but will need to wait until the effective date to reap the benefits.

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