Finding a Part D plan that meets your needs can be difficult, but it’s worth the time and effort to make sure you have access to the drugs you need at an affordable cost.
First, you should know what type of drug coverage you’re looking for. There are two types of Part D drug plans to choose from. Which one you should sign up for depends on how you get your Medicare health benefits:
- Original Medicare: If you want to get your health coverage through Original Medicare, choose a stand-alone Prescription Drug Plan (PDP) that only covers drugs.
- Medicare Advantage: Medicare Advantage plans are Medicare private health plans sold by insurance companies. They’re usually HMOs or PPOs. If you want a Medicare Advantage plan and Part D, you must generally get your drug coverage as part of your Medicare Advantage plan’s benefit package. Most Medicare Advantage plans come with a Part D component, but not all do. There are certain types of Medicare Advantage plans (such as Private Fee-for-Service plans) that will allow you to enroll in separate stand-alone PDP if they do not cover prescriptions. However, in most cases, when you have Medicare Advantage you must get your Medicare health and drug coverage through the same plan.
After you determine which type of Part D plan you should sign up for, you can start looking for a plan that meets your specific drug needs. Make a list of the medicines you take and how much you currently pay for them. You can ask your doctor or pharmacist for help making this list. Also write down the pharmacy or pharmacies you use regularly.
Then, go online to Medicare.gov and use the Plan Finder tool to search for plans that cover your drugs at the pharmacies you use. To use this tool, enter your zip code, your current coverage information, and your drugs and pharmacies. The Plan Finder tool will generate a list of Part D plans in your area that cover your drugs and have your pharmacies in their networks. You can also call 800-MEDICARE to do this search over the phone.
When you receive this list of Part D plans, compare them to see which covers the most prescriptions you need with the fewest coverage restrictions at the least cost. When you find a plan you like, call the plan directly to confirm the information, and keep a record of the call. Click here for a sheet to fill out when you call the plan.
Once you have made your choice, it is best to enroll in a plan by calling 800-MEDICARE.
Remember, when choosing a Part D plan, make sure you look at all the costs, not just the premium. Although a plan may have a low premium, other plans may have lower copays or deductibles, cover more of your drugs or have fewer coverage restrictions. If you’re signing up for a Medicare Advantage plan that includes drug coverage, you should also find out whether it will cover the health care services you need from the doctors and hospitals you prefer.
Remember to choose carefully. You can usually only change your Medicare health and drug coverage at certain times in the year.