Pick The Medicare Part D Plan That's Right For You!

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Tips and considerations for picking the Medicare Part D plan that will meet your prescription drug insurance needs.

If you qualify for Medicare, you’ll want to consider adding Medicare Part D to your plan. With an average of 33 Medicare Part D plans to choose from, however, it can quickly become overwhelming to determine which plan is right for you.

Here are a few things to consider when searching for a plan to best meet your prescription medication needs.

Compare costs

There are several elements you should consider when figuring what your Medicare Part D plan will cost you: your monthly premiums, your annual deductible, and the copayments you’ll make when you pay for your medications.

Your premium is the amount you need to pay each month to receive the benefits of your plan. The deductible is the amount you have to pay out of pocket before your Medicare Part D plan kicks in. And your copayment (sometimes called coinsurance) is the amount you pay for your prescription drug—typically a percentage of the total drug cost. Each of these costs varies between plans so be sure to compare them when selecting your plan.

You don’t want to choose based on cost alone, however. Having the cheapest plan won’t do you any good if it doesn’t cover the prescriptions you need. This is where the plan’s formulary comes into play.

Review the formulary

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A formulary is a list of prescription drugs covered by your Medicare Part D plan. It includes both brand-name and generic drugs and is divided into tiers, or levels, that have their own copay amounts. You’ll want to carefully review the formularies of each Medicare Part D plan you are considering. Check to make sure the plans carry the prescriptions drugs you need and find out their associated copay.

Determine what authorizations are needed

Some Medicare Part D plans require prior authorizations from your doctor before approving the cost of a prescription drug. Look at the plans you are considering to see if the medications you need require such an authorization. You’ll also want to determine if there are any limits on how often the drug can be prescribed over a period of time or whether there are any other restrictions to obtaining the prescriptions you need.

Verify how and where you can get your drugs

In reviewing your Medicare Part D plan choices, you’ll also want to look at how easy and convenient it is for you to obtain your medications. Check to see if your local pharmacy is included in the plan’s network. Ask if the plan has a mail-order program and, if so, whether it provides any cost savings. Find out how you can obtain your medications if you plan to travel a lot.

Use available tools to help in your selection

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Medicare’s online Medicare Plan Finder tool can help you select the right plan based on your location, the prescription drugs you currently use and the pharmacy you wish to use. Once you enter this information you can further refine your options by specifying how much you want to pay in monthly premiums or a yearly deductible, by selecting plans based on a rating system, by requesting plans that contain all your prescription medications in their formularies, and more.

Once you’ve entered this information you’ll see a list of available plans, which will help you compare costs, coverage and any restrictions the plan may carry. And remember, if you select a plan and later determine it does not meet your needs, you can always switch plans during the yearly open enrollment period, which lasts from November 15 through December 31. Your new plan would then begin on the first of January 1 the following year.

This article contains general information. Consult your financial or Medicare advisor before utilizing any of the information contained in this article.

Source: U.S. News & World Report, Medicare.gov, Kaiser Health News, HealthDay, My Medicare Matters, AARP
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