Have a checklist prepared
Before you began searching for Medicare Part D plans, have a list ready that you can refer back to. This will ensure that the plan you go with fits your medical needs and is within your price range. The list below can help guide you with your checklist
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1. Have a list of current prescription drugs.
The dosage, frequency (how often you take them), and quantity (if it’s a 30-day or 60-day supply) of your medications should be on a list that you use to ensure the plan you choose will cover them.
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2. Use the Medicare Plan Finder
Visit Medicare.gov to find out which Part D plans are available in your region. You’ll also be able to discover which plans will cover your medications. This tool is also beneficial if you already have a Part D plan but want to seek other options.
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3. Find out the price of plans
Part D plans are typically paid through a monthly premium plus the left-over out-of-pocket expenses you may have for your prescription drugs. With Part D plans, your prescription drugs are placed on a certain pricing tier. This is known as drug formulary and can cause you to pay more for your drugs.
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4. Prescription drug cost fluctuation
It can easy to choose the cheapest plan you see but be wary of making this decision. Whether it is generic or brand name, prescription drugs can affect the share of costs between you and your plan. Cheaper Part D plans are known to have higher out-of-pocket costs annually.
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5. View the ratings
Ratings are your best friend! Medicare provides ratings of Part D plans on a scale of 1 (terrible) to 5 (great). These ratings are based on a variety of factors, such as customer experience and complaints, performance, drug safety, and accuracy of pricing. Newer plans may not have any ratings yet.
Part D Restrictions
Many Part D plans come with restrictions for certain prescription drugs to ensure drug safety and control prescription drug costs. These restrictions can typically be found within the higher pricing tiers in a drug plan. Listed below are some of the commonly found ones:
- Quantity/dosage limits – Your plan may not cover your medication if it outside of the range (too high quantity or dosage) it has deemed necessary to treat your condition. Instead, your plan may approve a lower prescribed dosage or a shorter period for medication use.
- Step therapy – Your plan may require you to try a cheaper drug if your physician prescribes you an expensive drug.
- Preceding approval – A doctor’s or insurance company’s approval can be required by your plan before coverage is provided for your prescription.
But I don’t take prescription drugs
It may seem redundant or unnecessary to purchase prescription drug coverage if you don’t currently need it, but the future is uncertain. As the famous saying goes, you’d rather be safe than sorry. It’s best to sign up for Part D as early as possible to prevent any late penalties. Purchasing Part D coverage is just added protection in case your health condition worsens, and you need prescription drug coverage.
Although enrollment into Medicare Part A & B is automatic, enrolling in Part D as well is highly important to ensure your prescription drugs are being covered.