How To Choose The Best Medicare Part D Plan?
Claire Smith 14-06-2021

Find the Right Medicare Part D Plan For You

medicare part d plan

Prescription drugs can be critical to our day-to-day health so having the right drug coverage is critical to our well-being and peace of mind. Whether you’re new to Medicare or looking for a new plan this enrollment period, choosing Medicare Part D plans can feel a bit overwhelming. 

But don’t worry—we’re here to help. 

This step-by-step guide will help you through the process and ensure you get the prescription drug coverage you need at the right price.

But first, let’s get some basic information out of the way.

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What Are Medicare Part D Plans?

Medicare is a national, federal health insurance plan for those aged 65 and older. It’s designed to give health care coverage to those with inadequate or no coverage in place. Medicare has multiple parts to it:

  1. Part A: Hospitalization coverage
  2. Part B: Doctor’s visits and tests
  3. Part C:  Private insurance options for a combination of parts A, B, and D (also known as Medicare Advantage)
  4. Part D: Private prescription drug coverage

Prescription drugs are often a major part of healthcare, so having Medicare Part D plans is important. Medicare Part D needs to be purchased as a stand-alone policy in order to receive prescription drug coverage.

If you get Medicare Part C, for example, which includes drug coverage, you’ll be unenrolled from the drug coverage under Part D. 

What Do Medicare Part D Plans Cover?

Medicare drug plans from any insurer must meet the same standards as Medicare. This means that they all have to cover certain categories of drugs laid out by Medicare, but they can pick and choose which exact drugs to cover. If your exact brand of the drug isn’t covered, a similar option will be. 

Most insurance providers cover both generic and name-brand drugs, and they’ll list exactly which drugs they cover in something called a formulary. It’s important to note that the cost of each drug can vary from plan to plan, because of co-pays, tiered pricing, and more. 

How To Choose a Medicare Drug Plan?

Finding options for Medicare Part D is incredibly easy, but choosing the right plan for you is another story. It can definitely be overwhelming choosing Medicare Part D plan options, so this guide will walk you through it. 

  • Step 1: Browse the Medicare.gov Plan Finder to see plan options and find a wealth of information about plans and drug coverage. You’ll be able to check if your prescription medications are covered, if any nearby pharmacies are in-network, and even what you might have to pay out of pocket. The tool is incredibly helpful and actually does all the math for you to find the plan that keeps your costs lowest. 

  • Step 2: If you find a plan that looks right, make sure to check if it has any coverage caps or step therapy restrictions (which is when plans force you to try less expensive alternatives first). 

  • Step 3: Also check the plan’s exemption process; if you need to change medications or add one partway through the year and it’s not included in your plan’s formulary, you’ll need to file an exemption. Understanding what that process looks like ahead of time can help you decide whether to choose or reject a plan and save yourself a headache down the line. 

  • Step 4: Compare extra plan features that might benefit you, such as:

    • Automatic drug refills
    • Prescription home deliveries
    • Prescription refill reminders
    • Drug pricing tools to compare costs
  • Step 5:If you’re finding this process confusing, don’t be afraid to seek help. There are a variety of resources designed to help you navigate Medicare Part D plans, including:

    • Medicare’s Help Line
    • Local State Health Insurance Assistance Program (SHIP)
    • Local senior centers

This can quickly become an overwhelming process, especially if you have more than one prescription medication. Having a detailed understanding of your prescriptions, alternatives approved by your doctor, and dosages can help speed up the process immensely. 

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Final Thoughts on the Best Medicare Part D Drug Plan

The best Medicare Part D drug plan for you will be the one that costs you the least overall (including copays and deductibles) while giving you the drug coverage you need. It will ideally have little to no restrictions on what you need and be a highly rated plan.

While it might take quite a bit of upfront research, finding the right Medicare Part D plan can save you so much time and hassle down the line while also ensuring you have the coverage you need to be your healthiest. 

Claire SmithClaire is a creative entrepreneur with a variety of marketing and content creation skills, including blog and web copy writing, research, and strategy. She has a Masters in Cultural Studies from Queen's University and is known for thinking laterally about marketing, based on her deep knowledge of people and behavior.