Which Medicare Part D Plan is Right for You?
Whether enrolling in a Medicare Part D plan is in your near future, you still have
some time before eligibility, or you’re a caregiver searching on behalf of your
loved one, it’s never too early to start researching which Medicare prescription
drug plan is the right choice. When you enroll on time, you’ll avoid paying a Late
Enrollment Penalty (LEP), which would last for as long as you have Medicare prescription
drug coverage. Be prepared by having an idea of which prescription drug plan is
right for you.
Once you choose a Medicare Part D Plan, you will generally be enrolled in that plan
for a year. That’s why it’s crucial to select the right plan depending on your various
financial and health circumstances. Consider the following four points before choosing
a Medicare Part D plan:
Your Total Medicare Part D Cost
Look into all aspects of your prescription drug plan costs. Take a look at the plan’s premium (amount
you pay every month), deductible (amount you pay before the plan starts to
share the costs), copay (fixed amount you pay for prescription drugs after
the deductible is met), and coinsurance (fixed percentage you pay for
prescription drugs after the deductible is met).
Do these costs fit my financial capabilities? Am I comfortable
paying these prices?
Your Prescription Drugs
Every Medicare Part D plan has its own list of drugs, and every formulary covers
different prescription drugs. Check the plan’s formulary before enrolling to make
sure your prescription drugs are covered. Also, since formularies vary per plan,
your drug price can vary by plan as well, so shop carefully.
Is my drug covered by this plan? Does this plan’s formulary
offer the best price for my drug?
If you have a particular pharmacy you visit often, you should look into whether
the pharmacy is in a plan’s pharmacy network. In addition, some plans have preferred
and non-preferred pharmacies within their networks. You will pay a lower cost for your prescription drugs if you get them filled at one of the plan’s preferred pharmacies. If you choose to fill your prescriptions
at a network pharmacy that is non-preferred, you will pay a higher cost. Also, you may not be able to get a prescription covered under your plan if the pharmacy is not in the plan’s pharmacy network.
Is my pharmacy included in this plan’s pharmacy network? Is
it a preferred pharmacy? Am I willing to switch my pharmacy to one that’s in the
plan’s network in order for my drugs to be covered by the plan? Am I willing to
switch my pharmacy to one that’s preferred in order to pay a lower cost?
The current state of your health can help you decide which plan will best fit your
needs. If you have a health condition like diabetes, it may affect your plan choice.
For example, if the plan’s coverage of the drugs used to treat your health condition,
like diabetes, isn’t adequate, this may affect how desirable the plan is to you.
Also, if you take multiple prescription drugs, you have a higher chance of reaching
the Coverage Gap or “Donut Hole." This means you may want to consider a plan that offers coverage if
you reach the “Donut Hole.”
How many prescription drugs do I take? How much do I currently
spend on my prescription drugs?