Medicare Prescription Drug

How to Choose a Medicare Part D Plan

Each Medicare Part D Plan has its own list of covered drugs called a formulary.

Many plans place drugs into different tiers on their formulary. Drugs in different tiers have different costs. A drug in a lower tier typically costs less than a drug in a higher tier. If your drug is in a higher tier and your doctor thinks you need that specific drug instead of a similar one on a lower tier, you or your doctor may be able to ask for an exception to get a lower co-payment.
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How to Choose a Plan?
Now that you know a little more about how Medicare Part D plans work, here are a few tips to help you find a plan that meets your needs.
  • Examine the formulary. Start by making a list of all your prescriptions because you'll need to determine the total cost. You can find out by going to medicare.gov and using the 'plan finder' tool. Enter all of the drugs you use to find out where they are listed in the formulary and what the copays are.
  • Compare premiums. Premiums can vary significantly even when plans have the same coverage. By comparing plans, you can find the coverage you need at an affordable price.
  • Consider out-of-pocket expenses. Medicare Part D plans are allowed to charge a deductible of up to $320 in 2015. Once you meet the deductible, you may face a copayment or coinsurance charges. You'll need to determine if it's worth it to pay a higher premium in exchange for a smaller deductible and copayment.
  • Avoid restrictions. Some plans require authorization before you can fill certain prescriptions as well as quantity limits on how much medication you can get at one time. You may also be required to try one or more similar, low-cost drugs before your plan will cover a more expensive prescribed one.
  • Mind the coverage gap. If you have several prescriptions and know you'll likely reach the donut hole gap in coverage, you may want to find a plan that offers additional gap coverage. The higher premium may ultimately help you save money in the end.




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