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Medicare Part D - Comparing drug plans

In 2017, there are a total of 746 different Medicare Part D prescription drug plan options offered nationwide, according to the Kaiser Family Foundation (KFF). Most beneficiaries have a choice of 22 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, co-insurance, and co-payments, 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 are assigned by Medicare and are based on "information from member satisfaction surveys, plans, and health care providers," according to Medicare.gov.

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

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*You must continue to pay your Medicare Part B premium. $0 premium plans may not be available in all areas.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

Not all plans or products are available in all markets. Additional plans may be available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Last Updated: 09/12/2017 Pending Accepted

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