Medicare Part D - Comparing drug plans

In 2018, there were a total of 782 different Medicare Part D prescription drug plan options offered nationwide, according to the Kaiser Family Foundation (KFF). Most beneficiaries have a choice of 23 different plans.**

With so many options, it is important to compare plans and find one that works for your coverage needs and budget.

You can call 1-800-557-6059 to compare plans over the phone with the help of a licensed insurance agent.

You should make sure to compare the following 3 factors when choosing your Part D plan:

• Benefits
• Costs
• Star ratings***

You should try to enroll in a Part D plan when you are first eligible to do so. If you miss your Initial Enrollment Period, you may face a late enrollment penalty.

Compare benefits

Each Part D plan has a different range of benefits. Before enrolling in a Part D plan, you should request the plan’s current formulary (drug list), coverage rules, and network pharmacies.

Formulary and tiers

Each Part D plan covers different prescription drugs, which will all be listed on the plan’s formulary. You should find a plan that covers your prescribed medications. You may have to pay out-of-pocket for prescriptions that are not on a plan’s approved drug list.

You also should review the Part D plan’s tiers. Different plans may place the same drug in different tiers, which will affect your out-of-pocket costs. For example, one plan may put a certain brand-name drug in Tier 1, but another plan may put the same brand name drug in Tier 2, which could require a higher co-payment.

Coverage rules

Part D plans also have varying coverage rules that can affect your access to certain prescriptions. You should review the rules for quantity limits, prior authorization, and step therapy before enrolling in a plan.

Network pharmacies

Some Part D plans have contracts with pharmacies. If you visit in-network pharmacies, your prescription drug costs may be lower. If you fill a prescription at a non-network pharmacy, your plan may charge you more or not cover your medication costs at all.

Check to see if your preferred pharmacy is in your plan’s network.

More info: Part D benefits

Compare costs

Part D plan costs vary widely depending on plan premiums and out-of-pocket costs.

It is important to find a plan that fits your coverage needs and covers all of your prescription drugs before comparing plan premiums. If you enroll in a plan that does not cover all of your medications, you may be forced to pay out-of-pocket for these drugs.

In addition to plan premiums, you should compare other Part D plan out-of-pocket costs, including deductibles, coinsurance, and copayments, which may be different for each plan.

More info: Part D costs - premiums, deductibles, and the donut hole

Compare star ratings***

Medicare assigns star ratings to every available Medicare Part D plan. Part D plan star ratings give you an idea of the plan’s quality and performance.

Ratings range from 1 star (poor performance) to 5 stars (excellent performance).