There are many Medicare Part D plans to choose from. Although they are all similar in many ways, they are also different. One particular plan may be a better choice for an individual than another. There are four things you should consider when choosing a Medicare Part D plan.
1. How much does it Cost?
When looking at the costs, you need to consider the premium, the deductible, and the co-payments. The premium is the amount you will pay each month in order to have the insurance. This is a fixed cost. It is also important to look at how much the deductible will be, before your insurance starts paying for your medications. Lastly, consider how much you will pay in co-pays when you get a prescription filled at the pharmacy. If you take several expensive medications it may be a good idea to purchase a plan that has coverage in the gap. If you are dual eligible, or qualify for extra help, then you will probably want to choose one of the basic plans. The government will give "extra help" by covering the full premiums for certain Medicare drug plans, however those plans must be ones that charge no more than the average Medicare drug plan premium as compared to other plans in your area. If you choose a more expensive plan, you will have to pay the difference in premiums.
2. Are the medications I need covered by the Plan?
Each Medicare Part D plan has a formulary of medications that are covered. It is important to make sure the medications you are taking will be covered by the plan that you choose. Some medications require prior approval before a Medicare Part D plan will cover them. Look both at whether the medications you take are on the formulary, and whether they require prior authorization or step therapy. If a medication requires prior authorization or step therapy, then your doctor will have to talk with the insurance company to explain why the medication is needed, before it will be covered.
3. Where can I go to get my prescriptions filled?
If you want to be able to get your medications at a particular pharmacy, be sure to check and see which plans allow you to go to your preferred pharmacy. Bremo Pharmacy participates in most of the Medicare Part D prescription plans.
4. What medications will I need in the future?
Maybe you do not take many prescriptions now, but it is difficult to know what will happen in the future. It may be a good idea to join a basic plan, with low premiums. This would prevent paying higher penalty premiums for joining late, and will provide prescription coverage for unexpected prescription needs. If your needs change over time, you can always switch to a plan that works better for you during the next open enrollment.
Looking at all four of these factors at once can be confusing. Medicare has developed a very useful tool that helps compare plans, and find out which is most suitable for you. The tool is on the Medicare website at www.Medicare.gov. The tool allows you to enter where you live, the medications you take, whether you qualify for extra help, and what pharmacy you want to use. Results then show you which plans are the most affordable and meet your needs the best. The pharmacists at Bremo Pharmacy are very familiar with Medicare Part D. We are happy to explain how the Medicare Part D program works, and help you compare plans using Medicare's tool. Please call upon us if you have questions.
