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How to Choose a Medicare Part D Drug Plan

Medically Reviewed by Sarah Goodell on September 16, 2021

If you are eligible for Medicare, you’ve probably gotten a lot of offers for all kinds of prescription drug plans. With some research, you can find the right one for you.

Medicare prescription drug plans are also called Part D plans. They help you pay for prescription drugs. Medicare works with insurance companies and other private companies to offer many options for buying prescription medicines. You can compare Part D plans in your area by using the Medicare Plan Finder at www.medicare.gov. Look at each plan to see how much it costs, what drugs it covers, and what pharmacies it works with.

To get a Medicare prescription drug plan, you must already have Medicare Part A and Part B. You will pay for Part D in addition to what you pay for Parts A and B. If you have trouble with the cost, you may be able to get financial aid.

Weigh your options carefully. Once you sign up for a plan, you may not be able to make changes for a year.

Keep these things in mind to choose the plan that meets your needs:

Make sure the drugs you need are on the plan's drug list, called its formulary. A drug plan won't help pay for medicines that aren't on its list. Check the details carefully. Even if a drug is on the formulary, look closely to make sure it's covered at the dose and amount you need. Also, look to see if you must get your insurer's approval before the plan will pay for the medicine.

If drugs you need aren't listed, talk to your doctor before you enroll in a plan. They may be able to prescribe different medicines that will work as well.

Compare the costs. The deductibles, premiums, and copays or coinsurance for Medicare prescription drug plans will differ.

Check the pharmacies. Some plans will work only with certain pharmacies. Make sure that the pharmacy you use, or another one nearby, is on the list. If you like to have your medicines mailed to you, check for that, too.

After you make your choice, call the specific plan to find out how to enroll. You will probably receive a form in the mail that you can fill out and return. You can also enroll online.

For more information about Medicare prescription drug plans, see the Medicare website at www.medicare.gov or call 800-MEDICARE (800-633-4227).

In addition, each state has a State Health Insurance Assistance Program (SHIPs) with counselors available to help you understand your Medicare benefits and answer questions about your Medicare choices. You can find a SHIP at https://www.medicare.gov/contacts/#resources/ships.

If you have a Medicare Advantage plan, also called Medicare Part C, you may not need a Part D plan. Many Medicare Advantage plans provide drug coverage so ask your plan what’s included.

Show Sources

SOURCES:

Medicare.gov: "More savings in the drug coverage gap coming through 2020.”

News release, CMS.gov.

Medicare.gov: ''Medicare & You 2013," "Extra Help with your Medicare Prescription Drug Plan.”

Centers for Medicare & Medicaid Services: "Annual Release of Part D National Average Bid Amount and other Part C & D Bid Related Information." 

Kaiser Family Foundation.                

HealthCare.gov.

Center for Economic and Policy Research. 

Center for Medicare Advocacy.

Medicare Rights Center.

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