How to Choose a Part D Plan – The Annual Election Period is here! If you haven’t started looking at your current Medicare health plans, now is the time to do so! Almost all Medicare beneficiaries are on either a Part C (Medicare Advantage) or a Part D prescription drug plan, so this time of year is important to every single person on Medicare!
Today, we’re going to focus on how to choose your Medicare Part D plan.
Review the Drug Formulary
First things first. Gather your current list of medications so you can find out if all of them are covered under a plan’s drug formulary. Each insurance carrier has its own list of prescriptions that are covered, and you’ll want to choose a plan that includes all your medications. Some prescriptions are not covered by Medicare, but you’ll want to get as close as possible.
The drug formulary is organized into tiers. Most plans have somewhere between four and six tiers. Common, generic medications fall into lower tiers, while more specialized or name-brand medications fall into higher ones. Generally speaking, the higher the tier, the higher the cost.
Every Part D plan includes a monthly premium, annual deductible, and cost-sharing amounts. You want to find the plan that offers the least total expense for the year. That means that it’s not wise to choose a Part D plan based on the premium. A plan with a lower premium may cost you much more to refill your prescriptions than a plan with a higher premium.
Consider the monthly premium and total out-of-pocket costs to refill your prescriptions for the entire year. Add these two numbers to get your total for the year for each Part D plan you’re considering. Compare those numbers and see which plan comes in at the lowest cost.
Check the Pharmacy Network
Pharmacies can either be preferred, standard, or out-of-network. Preferred pharmacies will offer you the lowest prices, but you’ll still have coverage at standard pharmacies, too. Avoid pharmacies that are out-of-network, as you’ll have no coverage and will have to pay the full retail cost of the medication.
You may also consider using a mail-order pharmacy if your plan includes one. Most Part D plans offer lower pricing for mail-order medications, and you can get them in a larger supply, so you don’t have to request refills as often.
So, how can you complete all these steps? One option is to go to Medicare.gov. There, you’ll be able to enter your zip code, your medications, and your preferred pharmacy. You’ll be given a list of plans in your area, and you can sort them by the lowest total cost.
A better option is to contact your advisors at The Medicare Help Desk! We’ll go through a similar process but also share with you the ins and outs of each plan, so you know how to best utilize their benefits. Once you’ve picked a policy, we’ll complete your enrollment and make sure you’ve received everything you need for the upcoming year.
If you have not scheduled your Part D plan review, please call today! The Annual Election Period runs from October 15 through December 7, and applications must be submitted before the deadline.