When selecting a Medicare Prescription Drug Benefit plan, you need to consider several important things, including:
1. Deductible - many plans require that you pay a "deductible" - a specified amount out of your own pocket before Medicare D kicks in. This amount varies depending on your plan.
2. Monthly Premium - each Plan has a standard monthly premium, and the premiums vary from Plan to Plan. Remember to consider the overall cost of your medications PLUS the monthly premium, when calculating your annual drug costs.
3. Co-Pays - you will pay a minimum amount for each of your prescription medications. This amount is based on "tiers," numbered from 1 to 5. Drugs are placed on these tiers generally according to their relative cost. New medications cost more than older drugs, so some Plans will pay a higher percentage of costs for older medications than for the new ones. In some cases, the insurance provider will not cover (pay for) a medication on its drug formulary, so you are responsible for 100% of the cost of that medication.
4. Formulary - the drug formulary is the list of medications that the Part D Plan agrees to provide coverage for. Newer drugs tend to be on fewer formularies, due to cost and availability. It is vital that you look at the formulary of any Plan that you are considering, to ensure that your medications are included.
5. Available pharmacies - some Medicare Part D Plans are only available at certain pharmacies. While the majority of pharmacies are contracting with a large number of the Plans, some may not have a contract with the Part D Plan that you are going to select. Contact your pharmacy to see which Plans they contract with, so that you can keep both your regular pharmacy and the Plan of your choice.
Remember to consider all 6 key factors when making the decision about a Medicare Part D Plan, to ensure that you find the best Plan to meet your needs.
