logo

Helping People Find the Best Medicare Insurance
A fee-only financial advisor

1-877-236-7710

Contact us by e-mail

Finding the lowest-cost Part D plans for the prescription drugs that you take

People enrolled in Part A and Part B of Medicare must also have prescription drug coverage. Otherwise, they may later have to pay lifetime late-enrollment penalties. Their drug coverage can come from employer supplemental plans, Part D stand-alone plans, Medicare Advantage plans that include drug coverage, or Veterans Administration drug coverage.

Individuals can often lower their drug costs regardless of the type of plan they have. Among other steps they can take, they should use the least-cost refill schedule (retail or mail-order). If they are enrolled in a Part D plan (either a stand-alone plan or an Advantage plan that includes Part D coverage), it’s important that they review the plan during each year’s open enrollment period. Several large studies have shown that almost 90% of people in Part D stand-alone plans are not in a low-cost plan.

The only way to find the lowest-cost Part D plan for a specific set of drugs is to use the Medicare Plan Finder at the Medicare web site. Or call 800-MEDICARE or contact the local state health insurance program, which will conduct a plan search at no cost. Those who want to do it themselves can use the Medicare Part D Plan Finder using the instructions in the files at the bottom of this page.

Using Medicare's Prescription Drug Plan Finder

This file has step-by-step instructions for using the Medicare web site to find the lowest-cost Part D plans for the prescription drugs that you take.

Managing Medicare’s Costs

  • Using your computer to find the right Medicare Advantage plan

    Sometime later this year, Medicare Advantage plans will pass employer retiree plans as the most widely held type of Medicare insurance. Currently there are 20 million people in Advantage plans, more than twice the number ten years ago.

    While total Medicare enrollment has grown at slightly more than 3% a year during the last decade, Advantage plan enrollment has increased twice as fast.

    To keep pace with the influx of new enrollees, insurance companies have been rolling out additional Advantage plans. There are 283 more this year than last year, or a total of 2,317 plans, according to a report by the Kaiser Family Foundation.

    That’s the most since 2009, when generous government subsidies encouraged insurers to flood the market with plans.

    This year’s expansion has a potential upside. As the newer Advantage plans vie for market share, they need to offer attractive benefit packages. And that might put pressure on older plans to follow suit.

    The downside is that even before this year’s additions, in most parts of the country there were already too many Advantage plans. Retirees often complain in surveys that they are overwhelmed by having so many choices. This year, for instance, the average Medicare beneficiary can choose among 21 Advantage plans, according to Kaiser Family Foundation data.

    How do you sort through so many plans to identify the one that’s best for you? If you live in an urban area, your chances of finding an excellent plan are good. But if you live in the country, that may not be the case. This year there are 149 counties that do not have any Advantage plans and another 45 counties with only one plan. And more than one-fourth of U. S. counties have five or fewer plans.

    Even if you live in a remote outpost where there’s only one Advantage plan, you need to do some homework to avoid unpleasant surprises later. If you are computer savvy, you can easily find out quite a bit about a plan online. Or if you don’t want to do the research yourself, you can contact your nearest Medicare counseling agency for assistance.

    To do your own research, you’ll use the Medicare web site’s Plan Finder. There you can rank your area’s Advantage plans in various ways – by monthly premiums, costs for the prescription drugs you take, quality ratings, and so on. And by clicking on a plan’s name, you can see its benefits in greater detail. Here are the steps to follow:

    First, rank the plans by their costs for the Rx drugs you take

    Using Medicare’s Plan Finder and these step-by-step instructions, enter the names, dosages, and monthly quantities of the drugs that you take. If you do not take any prescription drugs, skip the drug entry and go directly to a list of the Advantage plans in your area. Then you can begin the sorting process.

    Let’s say you live in Atlanta, Georgia, and do not take any prescription drugs. When you sort the list of the 21 Advantage plans in the Atlanta area by their drug premiums, you see that 8 of them have annual premiums exceeding $400. That is too much to pay if you do not take any Rx drugs, and so you disregard these 8 plans and concentrate on the remaining 13.

    Within a couple of minutes, you can probably trim the remaining list down to 2 or 3 plans based on what you want in a plan. Possibly one of your doctors told you she is not in any Advantage plan networks. That leaves as your only choice an Advantage PPO plan. And among the 13 remaining Atlanta-area Advantage plans on your list, only two are PPO’s.

    Or maybe you want to consider only the plans that have at least a four-star quality rating from Medicare. In that case, only 4 of the 13 plans meet that standard. Perhaps you want a plan that has an out-of-pocket under $5,000, which will eliminate all but 3 plans.

    Examining the networks

    After you’ve weeded out most of the plans, the next step is to find out if your doctors are in the networks of the plans that are still on your list. Because the online provider directories for Advantage plans are often out of date, the most accurate way is to call your doctors’ offices. And if your doctors are in the network of only one of your finalists, it is likely to be your best option.

    Continue reading this post

Recent posts

Topics

© 2010-2018 Dover Healthcare Planning, LLC | Contact Us

Site by COPY & DESIGN