When Choosing a Part D Prescription Drug Plan, What Are Some Things I Should Consider?

Ask yourself the following questions before choosing a Part D drug plan:

  •  Does the plan cover all the medications I take?
  •  Does the plan have restrictions on my drugs (i.e. prior authorization, step therapy, or quantity limits?)
    •  Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug.
    •  Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one.
    •  Quantity limits restrict the quantity of a drug you can get per prescription fill, such as 30 pills of Drug X per month.
  •  How much will I pay for monthly premiums and the annual deductible?
  •  How much will I pay at the pharmacy (copay/coinsurance) for each drug I take?
  •  Is my pharmacy in the plan’s preferred network? You pay the least if you used preferred network pharmacies.
  •  Can I fill my prescriptions by mail order?
  •  If I have retiree coverage, will the Medicare drug plan work with this coverage?
  •  What is the plan’s star rating?

You may find it helpful to use Medicare’s Plan Finder tool (see What is The Medicare Plan Finder?), which gives you a list of Medicare Advantage and Part D plans, the drugs they cover, and their estimated costs for the year. You can access Plan Finder by going online at www.medicare.gov or calling 1-800-MEDICARE.

Read Next:  When Choosing a Medicare Advantage Plan, What Are Some Things I Should Consider?
Find Out: How Do Star Ratings Work?
Return to: Medicare 2021

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