Comparing Part D plans is more than just finding a low monthly premium
If you’re new to Medicare you may be surprised to know that most people have about 30 Part D plans available from which to choose.
Certainly how much you pay in monthly premium is important but there are many other factors to consider. And you may find it surprising that the monthly premium is not the most important factor to consider when comparing Part D plans.
The following video will outline a methodology to follow so you can enroll in the best plan for your circumstances.
Comparing Medicare Part D – tips
The method for comparing plans includes; determining what factors are important and knowing what resources you have available to make a sound comparison.
All of the following factors should be taken into account when comparing Part D plans:
- That all your drugs are covered
- Overall cost is affordable
- Gap coverage is adequate if needed
- Pharmacy network is favorable to your location
- Mail order pharmacy offers real benefit
Finding a plan that will cover all your drugs is actually more important than finding a plan with a low monthly premium. The lowest premium will not be a benefit if your drugs are not covered by the plan.
Overall Part D costs include; premiums, deductible (if any), and coinsurance and copayment amounts.
The Affordable Care Act will afford you some discount while in the coverage gap (aka: Part D Donut Hole) but many plans with enhanced formularies will offer additional coverage while in the gap.
If you feel that you will reach the gap this becomes a more important factor than if you take very little medications and find it to be unlikely that you will reach the gap.
Most Part D plans include 60,000 plus pharmacies but it doesn’t hurt to check to be certain that your favorite pharmacy is included.
If you require maintenance medications that you must take daily for long periods of time, check the mail order benefit is recommended.
Some plans may include very generous benefits if you receive your Part D drug through the mail.
Why do Part D premiums differ so much
Certain factors will have an impact on how much your monthly premium will be for a given plan. Factors effecting premiums include:
- Formulary – list of covered drugs
- The deductible amount
- Whether or not there is extra gap coverage
- The overall amount you contribute in the form of copayments and coinsurance
A plan with a basic formulary, the maximum deductible, no extra gap coverage and average cost sharing amounts should result in the lowest monthly premium.
Resources for comparing Part D
The number one resource for comparing Part D plans are the formularies for each plan. The formulary will not only include a list of all covered drugs, but additionally, will list which tier each drug is listed in.
The higher the tier, the greater your share of the cost. The same drug may be listed in different tiers by competing plans. The amount you pay for a drug could vary significantly between plans.
A good source of information when you start to compare plans is the Medicare website. This will give you a top-level view and to drill down into the benefits of a specific plan you can visit that plan’s website.
You can also visit online quote engines to Compare Medicare Plans.
If you would like to see all plans listed for all 50 States and Washington DC, visit www.PartDPlanFinder.com.
You will be able to compare:
- Formulary type (basic or enhanced)
- Gap coverage
- Medicare star rating
The main thing to consider when comparing Part D plans is to start early so as not to miss an enrollment period and find an affordable plan that includes all your required medications.