Shopping Medicare Part D Plans

When choosing a Medicare Part D plan, don’t base your decision solely on the monthly premium.

1. Medication Coverage (Formulary)

Each plan has a formulary, which is a list of drugs it covers. Just because a plan is cheap doesn't mean it covers the specific medications you need. If your prescription isn’t covered, you could end up paying the full cost of the drug out of pocket.

2. Drug Tiers

Medicare plans categorize drugs into different cost tiers. A lower-cost plan might place your medication in a higher tier, meaning you'll pay more in co-pays or co-insurance. It's crucial to check how your specific drugs are tiered within each plan.

3. Pharmacy Networks

Plans often have preferred pharmacy networks. If you use an out-of-network pharmacy, you might pay more, or your plan might not cover your drugs at all. Make sure your regular pharmacy is within the plan's preferred network.

4. Deductibles and Out-of-Pocket Costs

Some plans come with a low premium but have high deductibles or co-insurance fees. A plan with a higher premium might save you money in the long run if it has lower deductibles or better coverage for your medications.

Choosing a Medicare prescription drug plan involves more than just comparing prices. Always review the formulary, pharmacy network, and potential out-of-pocket costs to find the best option for your specific needs.

**Please note that we recommend shopping your plan using the total estimated cost filter, not by plan or drug cost alone.

Visit Medicare.gov for more information or to schedule an appointment.