Comparing Part D Plans – A Step-by-Step Guide to Using Medicare.gov

This article is re-posted (with revised dates and updated information) from a previous blog post in 2013.

Comparing Part D plans is an essential task for those on Medicare. Part D is the part of Medicare that covers prescription medications, and frankly, is often the most confusing and complex part of Medicare. It can also be the most expensive, particularly if you have chosen the “wrong” Part D plan.

Part D has an annual enrollment period (contrary to Medicare Supplement plans, which do not). This year, the Part D annual enrollment period, or AEP, runs from October 15 through December 7. Any changes made to your coverage during this time period will take effect on 1/1/16.

So, why do you have to compare plans each year? Can you not just choose a plan and stay with it? Yes, you certainly can stick with the plan that you have now. If you take no action during AEP, your plan will carry you into the next year (as long as it is not being discontinued). But, this is not always a wise strategy. Many things about the plans change from year to year.

Each year, insurance companies have to have their plan outlines/designs approved by the Centers for Medicare and Medicaid Services (CMS). Medicare/CMS sets forth minimum guidelines that they must maintain, but they can expand on those as they see fit. Typically, premiums, deductibles and co-pays on each plan change each year. Also, there is the variable of your actual medications, which may have changed and may make a different plan a better option.

So, how to do you compare the Part D plans. Fortunately, Medicare has put all of the plan information on their website (2016 information will be available around 10/1/15). However, the site is not always very user-friendly. Here are the steps to follow to compare the Part D plans:

  1. Point your web browser to http://medicare.gov.
  2. Click the green button named “Find health and drug plans” (mid-way down, left hand side).
  3. Enter your zip code and click “Find plans”. You may be prompted to enter your county (if your zip code spans multiple counties) – if so, select your county and click “Continue”.
  4. Answer the next two questions and click “Continue”.
  5. This will take you to the drug entry screen. You should enter your medication names exactly as they are listed on the label (in other words, don’t list the brand name if you take a generic equivalent). Then, select the dosage and frequency when prompted. Once you have entered them all, select “My Drug List is Complete” (below the drug names).
  6. Next, select your preferred pharmacy. This is important as co-pays etc can vary on some plans from one pharmacy to the next. Choose the pharmacy that you use now or would most likely use and click “Add Pharmacy” below the pharmacy name. Then, click “Continue to plan results” at the bottom of the screen.
  7. Under “Summary of search results”, select ONLY the checkbox beside “Prescription Drug Plans”. Then, click “Continue to plan results”.
  8. This brings up all the plans for your area and the results are sorted by “lowest estimated annual retail drug costs”. In other words, the plans are listed in order of which plan would cost the least to you over the course of an entire year, taking into account premiums, deductibles, and co-pays for your specific medications (that you entered).

This is truly the best way to compare Part D plans. You can even sign up for the plan you want right there on the Medicare website, or you can get information about contacting to company to enroll. It is a little cumbersome and time-consuming, but the savings that can result are significant. Each year for the last 10 years, I have had a client save $2000+ on Part D costs simply by changing plans to one that fits their medication profile better.

We perform the Part D comparisons at no cost for our Medicare clients, as most independent agencies do (or should do). If you want more information or have questions, please contact me online or call us at 877.506.3378.

How to Compare Medicare Part D Plans

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:

  1. First, go to http://www.medicare.gov.
  2. Click on the orange button in the middle left of the screen that says “Find health and drug plans”.
  3. 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.
  4. Answer the two questions on the next screen and click “Continue to plan results”.
  5. 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.
  6. Once you have entered your medications, go to the bottom and click the orange button that says “My drug list is complete”.
  7. 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”.
  8. This brings you to “Refine your plan results”. On this screen, check the box beside “prescription drug plans” and click “continue to plan results”.
  9. 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”. More and more people are become introduced to quartz banger. With tasty new strains of concentrates coming out, everyone wants to enjoy their wax to the fullest. 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.

Medicare Enrollment Period – What Changes Can You Make?

The Annual Election Period (AEP), or Medicare Enrollment Period, as it sometimes called, is the period of time during which some changes can be made to your Medicare plan coverages. There are many misconceptions about this period and what changes you can make during it. It is important to understand how this period works and exactly what steps you need to take during this period to ensure continued quality Medicare plan coverage.

Original Medicare – Parts A & B
If you are already on Medicare Parts A & B, you do NOT need to do anything during this period to continue to have Medicare coverage. If, however, you do not have Medicare Part B yet, you can sign up at this time for it to take effect on 1/1/13. This is useful if you are leaving, or losing, employer group coverage.

Medicare Part D
Medicare Part D is probably the most important thing to understand, as it relates to the Medicare enrollment period. This is the only time of year that you can change your Part D prescription drug plan. Part D plans do change each year, so it is essential to know how your plan is changing and make sure it is still the most advisable choice for you. You will receive a plan notice of change around October 1 – this will detail how your plan is changing for the next year. Often, plan premiums, deductibles, co-pays, tier structures, etc. will all change on a plan from year to year. You can compare all of the plan options to make sure yours is still the best for your current needs by using an independent brokerage (like Medicare-Supplement.us!) or by going to the Medicare website (www.medicare.gov). Either way will allow you to choose a plan based on your current medication needs.

Medicare Supplements (Medigap)
Contrary to popular misconception, you can actually change Medigap plans at any time of the year. The end of year period is a good time to do it, particularly if your plan rates have changed during the year. However, you can do it at any time. You can enroll in, disenroll from, or change your plan to another option. Because these plans are Federally-standardized, coverage is the same with every plan. For example, a Plan F with one company is the exact same as a Plan F with another company. So, if you can find a lower-priced option for the plan you have, and are able to change, switching plans is a wise thing to do to reduce your premium costs.

Medicare Advantage
Medicare Advantage is the type of plan that replaces Medicare – basically, it is a privatized version of Medicare. The Annual Election Period (October 15-December 7) is the only time of year that you can make changes to this plan (unless you fall in a special election period circumstance – i.e. losing other coverage, moving out of your plan’s area, etc.). So, if this is the type of plan you have chosen, it is wise to make any changes to it at this time. You can compare the other options and make changes as necessary.

If you have any questions about the Medicare enrollment period, please contact us at Medicare-Supplement.US or call us at 877.506.3378. Medicare-Supplement.US is an independent Medicare insurance brokerage that can assist you with comparing the plan options and choosing a suitable plan.