Prescription Drug Plan (Medicare Part D)

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How to select a Prescription Drug Plan

To get the best Medicare Part D Prescription Drug Plan that works for you,  we analyze the premiums and co-pays related to your drug list (the medications and dosages you use) for drug plans offered in your residential area.

 

Drug plans run for a calendar year and you have to stay with that plan for a full year unless you have a special circumstance such as moving out of the area or a plan notifies you that they will be no longer be available in your residential area.

 

Open enrollment for selecting a different drug plan runs from October 15 to December 7 each year.  New plan start dates begin January 1 of each year.  If you do not select a new plan, the one you are enrolled in continues for another year.


Drug Coverage

Every Prescription Drug Plan (Medicare Part D) includes a formulary, or a list of drugs, covered by that plan. Most Medicare drug plans organize drugs according to different "tiers" in their formularies. Each tier represents different drug costs. Usually, drugs in lower tiers have a lower cost than drugs in higher tiers.

Drug Costs

The amount your drugs cost you may change based on: 

  • How your drugs are "tiered" in your plan's formulary
  • Your pharmacy choices in your plan's network 
  • Mail Order (90 day) vs.  Pharmacy (30 day) 
  • Whether you can receive Extra Help for Part D costs

Financial Assistance for Prescription Drugs

It’s possible that you might qualify for Extra Help from Medicare to offset the costs of Medicare prescription drug coverage, if you satisfy specific income and financial resource limits. 


In 2019, costs are no more than $3.40 for each generic/$8.50 for each brand-name covered drug. Based on their income level, some people pay only part of their Medicare drug plan premiums. 


In 2018, it’s possible that you will qualify if your annual income is $18,210 or more ($24,690 for a married couple) and up to $14,100 in resources ($28,150 for a married couple). 


If it’s determined that you don’t meet the requirements for Extra Help, there may be programs in your state that can help offset the cost of your prescription drugs. Get in touch with your state’s Medicaid office or the State Health Insurance Assistance Program (SHIP).


If your finances disqualify you from receiving Extra Help, there may still be programs offered in your state to assist in your payment for your prescription drugs. Call your state Medicaid office  and request more information from your  State Health Insurance Assistance Program (SHIP)

  

Please keep in mind that changes in your income or financial resources may help you qualify at a later date so be sure to reapply at that time. 


Financial resources that may be taken into consideration include:

  • Available funds in your savings or checking accounts
  • Stocks
  • Bonds

 

 Above information resourced from www.medicare.gov.