How to Choose a Medicare Prescription Drug Plan

With the Annual Election Period (AEP) coming up from October 15-December 7, it is a critical time to review your Medicare Plan.  Because of the limited time frame, you’ll be receiving A LOT of advertisements—by mail, email, social media, radio, newspapers, phone calls, and television.  It WILL be overwhelming!

Medicare Prescription Drug Plans cover medications.  Some people have their Prescription Drug Plan built in to their Medicare Advantage Plan, and some people have a stand alone Prescription Drug Plan.  Regardless of how you receive your prescriptions, it makes sense to review every year!

Most states have a large number of Prescription Drug Plans to choose from.  For example, in Illinois alone, there are 27 different plans to choose from.  How do you narrow it down?

Some things to consider:

What are your medications?

• Each plan has a formulary, or drug list.  These formularies are not the same from plan to plan.  Checking YOUR medications against each plan’s drug list is important. You don’t want a big surprise that your medication isn’t covered for 2019. 

What pharmacy do you use?

• Each plan has a network of pharmacies.  Some plans have broader networks, and some are very specific to a certain pharmacy.  Most, but not all, have mail order vendors that can reduce the cost. 

What is the plan premium?

• The plan premium is important, but the overall cost (premiums, deductibles, and co-pays) is the most important factor.

What is the deductible?

• Medicare’s standard deductible is $415 for 2019.  Some plans include this full deductible, some have a lower deductible, and others have $0 deductible.  Some of the plans have a deductible on only certain levels of medications.

What are the medication co-pays?

• Each plan has a variety of medications tiers, or levels.  Typically plans have 5 tiers of medications.  Check which tiers your medications are on to see what your co-pays will be.

As you can see, there is a lot to consider when analyzing a drug plan.  One handy tool is the medicare.gov plan finder, where you can input your medications and your pharmacies. Also, your area’s Senior Center likely has SHIP counselors who can do these reviews for you. 

We do Prescription Drug Plans reviews and analysis in my office as well, so if you’d like assistance, please give us a call.  

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Author

​Angela Damin, Your Medicare Teacher, is an award winning Medicare planning broker with over a decade of experience in the Medicare field.  She meets people in person, over the phone, and via video chat.  Angela has a Masters Degree in Education and taught elementary school before  switching her subject matter to the Medicare realm. She spends her spare time chasing her twin toddlers.