Helpful Tips for Choosing a Medicare Part D Plan

Updated on August 3, 2020
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Once you retire, health care costs, particularly your prescription drugs, can be a significant expense. In fact, the average cost of care for widely used generic drug products was $365 and for brand name drugs, $6,798. Regardless of if you require prescription drug coverage from a Medicare prescription drug plan when you sign up for Medicare, it’s best to plan ahead.

At some point during your retirement years, it’s likely you will require this coverage. If you are uncovered and you need any prescription drugs, the cost may be devastating to your financial situation. Also, if you put off signing up for this coverage until you actually need it, you are probably going to pay a much higher premium.

If you are eligible for Medicare, you have two basic options – you can get a stand-alone Medicare Part D prescription drug plan, or you can choose an “all in one” option with the Medicare Advantage plan. Here you can learn more about the Medicate Part D plan and making sure you get adequate coverage.

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A Checklist for Your Medicare Part D Plan

It’s important to note that not all Part D plans are created the same. Every plan will vary based on the cost, special rules, the drugs covered, and other factors. Keep in mind, just because you know someone that has a Part D plan that works for their particular needs, it doesn’t mean the same plan is going to work for you. This means you have to do your homework. Some steps to help you get started are found here.

Create a List of All the Prescription Drugs You Are Currently Taking

While listing the name of the drug is a good first step, don’t stop there. You also need to list the dosage, and quantity – a 30-day supply, 90-day supply, etc. Be sure to write down the frequency you take each drug, as well.

Take the List to the Medicare Plan Finder

This is a handy tool offered by Medicare.gov that shows you the Part D drug plans that are available in your area and which of the plans will cover the drugs you are taking. It’s also possible for you to use the plan finder every year to check and see if there are better Part D options for you to consider.

Compare Costs

Once you have found the plans that will cover your prescriptions, it’s time to see the associated cost for each one. The cost will usually be the monthly premium, which is what you have the Medicare Part D plan pay and the out-of-pocket costs that you will pay for the drug. While one Part D plan may provide coverage for your drugs, you may have to pay more cared to another plan, depending on the pricing tier that the plan puts your prescriptions in (this is called drug formulary).

Understanding the Possibility of Cost Fluctuation

It’s important for you to understand that your share of prescription drug costs may fluctuate based on the category of drug you have selected – brand name or generic. If you are interested in the plan with a lower monthly premium, be sure you consider the overall cost of the plan each year, which combines the premium along with your out-of-pocket expenses.

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Look at the Ratings

Each of the Part D plans that are available have received a rating from Medicare ranging from 1, which is poor, up to 5, which is excellent. These ratings are based on overall customer service, the customer experience, total complaints, drug safety, performance, and how accurate the pricing is. The ratings can help you figure out if the plan is doing a good job in providing coverage. Remember, the newer plans may not yet be rated.

As you can see, there are several factors that must be considered when you are ready to choose your Medicare Part D plan for prescription drug coverage. Be sure to keep the information here in mind so that you can find the plan that best suits your needs and your budget. There are experts that can help you with this if needed, so keep this in mind too. 

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