Medicare Part D is your prescription drug coverage. It’s offered by private carriers and there are usually many different plans to choose from. So, how do you pick the best plan?
Medicare Part D Basics
Medicare Part D is one way you can access prescription drug coverage. The other, of course, is Medicare Advantage. Remember, Original Medicare and Medicare Supplement Plans do not offer prescription drug coverage.
Part D Plans are federally regulated but they are offered by private carriers. So, the Federal government sets certain criteria that all plans must adhere to at a bare minimum. However, because the plans are offered by private carriers, the carriers often offer better benefits to compete for your business. So, how do you know which plan is right for you?
Our advice is, of course, to work with a broker. A broker works for you, not the insurance carrier. They can help you compare all the different plans available to match you with the plan that best matches your needs and budget. Make sure to work with a licensed broker! And as a side note, many brokers do not charge for their services so you’ll get a little extra bang for your buck if you work with a broker who does not charge any additional fees.
If you want to do the legwork on your own, then you’ll need to utilize Medicare.gov.
When you access the plan finder on Medicare.gov, you’ll want to be as specific as possible. Ideally, you should be able to input your preferred pharmacies and the names of any medications you currently take. After your list of available plans populates, you’ll have to make decisions based on:
Premiums & Deductibles:
Generally speaking higher premiums mean lower deductibles and vice versa. If your prescription drug needs are extensive, you may want to consider a plan with higher monthly premiums if it waives or lowers the deductible significantly (especially if it offers lower copays as well). If your prescription drug needs are not as extensive, then a plan with a higher deductible, but lower monthly premiums may be better for you.
RX Drug Costs & Yearly Costs:
Medicare.gov will also estimate your yearly costs for the drug(s) that you’ve entered plus the annual cost for your monthly premium. You’ll need to weigh this with your deductible because you’ll have to pay that amount out of pocket before the cost sharing begins.
Copays & Coinsurance:
Different tiers of medications have difference prices during the stages of Part D. Although the federal government sets limits, certain plans may offer lower copays or coinsurance. This can also be affected by the pharmacies you choose.
Make sure that the plan you choose is accepted at your pharmacy of choice. If you can be flexible with the pharmacy you use, you may save money. Additionally, you may be able to save money by using a mail in pharmacy.
Insulin Savings Program
If you take insulin to manage your diabetes, you may want to enroll in a plan that participates in the insulin savings program. These plans guarantee a 30 day supply of insulin for no more than $35. This can be a major cost savings.
Part D Enrollment
Remember, there are only certain times in which you can enroll in a Part D Plan. Ideally you’ll enroll in a plan during your Initial Enrollment Period (IEP) which is the 7 months surrounding your 65th birthday. You can also enroll during the Annual Enrollment Period which is every year from Oct. 15-Dec. 7. Coverage becomes effective Jan. 1. But, remember if you go for a period for more than 63 days without creditable coverage, you may be subject to a late penalty which will be tacked on to your monthly premium forever.
If you’d like our assistance, you can reach us here iHealthBrokers at 888-918-0518 or schedule a call today. Our services are 100% FREE.
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.