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 $405 for 2018 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.
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.