Medicare Supplements (Medigap) plans are relatively straight-forward. The plans fill in the “gaps” in Medicare. They are Federally-standardized, so every company provides the same coverage plans. They do not have networks, so you can go to any doctor or hospital that accepts Medicare. Claims are automated through the Medicare “crossover” system, so all of the plans are the same in that regard. Put simply, navigating Medicare Supplement plans and choosing a plan is much less painstaking that many people make it out to be.
All that said, the same cannot be said regarding Medicare Part D Rx plans. Medicare Part D is very complex – there are approximately 30-40 plans offered in each county. The plans vary in: premium, deductible, tier structures, pharmacy networks, co-pays, prior authorization requirements and other areas. Choosing a Part D plan can be extremely difficult and time-consuming.There are a few steps, however, that you can follow to make sure that the plan you choose is the right one for you.
First of all, we would always recommend choosing a plan based on your current medication needs. Obviously, your needs may, and probably will, change over time. But you can always change your Part D plan during the annual enrollment period each year if your needs or the plan itself changes. The annual enrollment period runs October 15-December 7 each year. The plans do change each year in most cases, so it is a good idea to re-evaluate your plan each year, regardless of whether your medications have changed.
So, how do you compare the plans based on your medications? Medicare.gov, Medicare’s website, has a tool online that allows you to do this. Currently, we do this, as a free service, for our Medicare Supplement clients on an annual basis, although we do not sell most of the plans. But if you are not one of our clients or just want to run this comparison yourself, follow the instructions below:
- First, go to http://www.medicare.gov.
- Click on the orange button in the middle left of the screen that says “Find health and drug plans”.
- This brings you to a screen to enter your zip code. Enter it there and click “Find plans”. Select your county in the pop-up window if prompted to do so.
- Answer the two questions on the next screen and click “Continue to plan results”.
- This brings you to the “Enter your drugs” screen. You should enter them as completely as possible for most accurate results. Make sure you use the generic name if you are on a generic version. Use the correct dosage if possible.
- Once you have entered your medications, go to the bottom and click the orange button that says “My drug list is complete”.
- This brings you to step 3… “Select your pharmacies”. Select the pharmacy that you use now or would most likely use. This CAN have some effect on your co-pays, etc. so it is a good step to enter this accurately. Once you have done that, click the orange button that says “Continue to plan results”.
- This brings you to “Refine your plan results”. On this screen, check the box beside “prescription drug plans” and click “continue to plan results”.
- This brings up your plan results. These can be difficult to decipher, but the most important things to look at are the “Estimated Annual Drug Costs”. These take into account any medications that you entered, as well as the premium and deductible of the plans. By default, the plans are ranked according to lowest overall annual costs.
If you have any questions about this process or figuring out how to compare Part D plans OR if you wish to compare Medicare Supplements plans by email, please contact me on our website or call me at 877.506.3378.