How to Find a Better Medicare Prescription Drug Plan
Dear Savvy Senior,
Is it important to compare Medicare Part D prescription drug plans every year? My pharmacist highly recommends it, but it’s such a hassle sorting through all those different plans. Is there an easier way to shop and compare Medicare drug plans?
Because Medicare’s prescription drug plans can change their costs and benefits from year-to-year, comparing Part D plans every year during the open enrollment season (which is Oct. 15 – Dec. 7) is always a smart idea.
Even if you’re happy with your current coverage, there may be other plans out there that you’re not aware of that offer better coverage at a lower cost. You never know until you look. Here are some tips to help you shop and compare Medicare drug plans.
If you have internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area and enroll in a new plan online if you choose, and it only takes a few minutes.
Just go to Medicare’s Plan Finder Tool at Medicare.gov/find-a-plan, and choose the type of coverage you’re looking for, enter your ZIP code, financial assistance (if you receive any), select the drugs you take and their dosages, and choose the pharmacies you use. The plan finder does the math to identify the plan in your area that covers your drugs at the lowest cost.
This tool also provides a five-star rating system that evaluates each plan based on past customer service records and suggests generics or older brand name drugs that can reduce your costs.
When you’re comparing drug plans, look at the estimated drug costs plus premium costs that shows how much you can expect to pay over a year in total out-of-pocket costs.
Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.
Any changes to coverage you make will take effect January 1. If you take no action during open enrollment, your current coverage will continue next year.
Related: Medicare Part D Penalty Costs WHAT?
If you need some help choosing a new plan, you can call Medicare at 800-633-4227 and they can help you out over the phone. Or contact your State Health Insurance Assistance Program (SHIP), which provides free Medicare counseling. They also conduct seminars during the open enrollment period at various locations throughout each state. To find a local SHIP counselor see ShiptaCenter.org or call 877-839-2675.
If you’re lower-income and are having a hard time paying your medication costs, you may be eligible for Medicare’s “Extra Help” program. This is a federal low-income subsidy that helps pay Part D premiums, deductibles and copayments.
To be eligible, your income must be under $19,320 or $26,130 for married couples living together, and your assets (not counting your home, personal possessions, vehicles, life insurance policies or burial expenses) must be below $14,790 or $29,520 for married couples. For more information or to apply, call Social Security at 800-772-1213 or visit SSA.gov/extrahelp.
Send your senior questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.
Originally published September 30, 2022