How to Select the Right Medicare Prescription Drug Plan for You

If you’re on Medicare and take prescription drugs, this won’t surprise you: The costs of medications are rising fast. Up an estimated 12.6 percent in 2014, prescription drug costs are projected to rise by an average of 7.3 percent annually, according to U.S. Department of Health and Human Services.

But that doesn’t mean you have to bear the brunt of these increases. With the right planning and strategy, you may be able to lower your Medicare drug costs—or at least prepare for rising costs. It starts with choosing the right prescription plan for you.

It’s important to know that insurance companies can revise their formularies throughout the year and Medicare Part D drug lists are updated on an annual basis. This means that your prescription benefits—your premiums, deductibles, copayments and list of accepted medications—can change throughout the year or drastically from one year to the next. This is why it’s important to keep current with your prescription benefits. Follow these tips to help you select drug benefits before committing to a plan during open enrollment:

Make a list of the medications you expect to take over the next year. 

Research your options. Review Medicare Advantage plans and/or insurance plans with a Medicare Part D drug plan and select three to compare. To help gather information and narrow your choices, you can:

• Check the Center for Medicare and Medicaid Services (CMS) website to compare plans and drug formularies.
• Call your State Health Insurance Assistance Program and speaking to a representative. Click here to get the telephone number and web address for your state.                      
• Talk to your pharmacist. Many pharmacists are knowledgeable about different drug plans.
• Compare total annual drug costs. One of the best ways to evaluate a Medicare Part D drug list is by costs, i.e., premiums, deductibles and out-of-pocket expenses. If you have a Medicare Advantage plan, you may skip this step, as drug costs are folded into the plan.

Check the formulary. This is simply a list of covered medications. Once you found a plan that you like (even if it’s your current plan), make sure your medications are covered and the copayments are clearly defined. It’s common for plans to remove previously covered medications and change drug cost tiers on a yearly basis. Brand-name medications usually go through formulary changes more often than generic drugs; and costs for expensive drugs can vary greatly from plan to plan.

Find out all of your costs. Before committing to a plan, make sure you understand all of the inner workings of the plan. For instance, many drug plans charge coinsurance for brand-name and specialty drugs. You also may be charged different amounts based on the pharmacy you use.

Ask yourself if this plan will work for you. Do you like the pharmacies that are contracted? Does it offer a mail-order program?

Be open to selecting different plans for you and your partner.  A plan that may work for you may not be the best choice for your significant other.

Make a decision regarding the type of plan you want before contacting an insurance agent. Knowing what type of plan you want will enable your insurance agent to quickly narrow down the best options for you.   

Sign up for Medicare before you turn 65. Medicare adds a one percent of the national base beneficiary premium, which was $34.10 in 2016, onto your monthly premium for every month your Medicare registration is delayed. To avoid penalties, you can register for Medicare three months before you turn 65.

Visit Medicare Pharmaceutical Assistance Program to find manufacturer discounts on medications.

Finally, talk to your MDVIP physician. They will work with you to determine the best medications for you and may be able to help you lower prescription drug costs.