6 Things to Know About Medicare Drug Coverage

You know that a Medicare Part D plan can help you to manage your prescription drug costs. But with a variety of different plans on the market, how do you choose one? For many people, we find that these 6 tips help them narrow their options and lead to identifying the Part D plan that is right for them.

Each plan has a “formulary”. This is the list of drugs covered by the plan. If you regularly take certain medications, your first priority should be to check a plan’s formulary to discover whether that plan will cover your needed medications.

The “coverage gap” can be costly. After your prescription costs exceed a certain level each year, you will begin to pay a higher cost share until you reach the threshold for catastrophic coverage. This coverage gap can be costly, but some plans do address this problem. If you suspect that your drug costs will be high enough to put you into the coverage gap, it is important to choose a plan that will cover your needed drugs while in the gap.

You can plan for surprise costs. Lower drug costs doesn’t necessarily translate into even expenses throughout the year. If you want to keep your prescription drug costs consistent from one month to the next, investigate low- or no-deductible Part D plans.

Certain common medications might fall into a low-cost tier. Part D plan formulariies are arranged into “tiers” according to drug costs. Many common generic prescriptions fall into a bottom tier, which means you will be charged nothing or only a very low copayment when filling those prescriptions.

Even people who don’t use many medications can benefit from a Part D plan. If you rarely need medication, a low-premium Part D plan might work well for you. The monthly cost is low, but you will still have coverage for most medications in the event that an unforeseen accident or illness makes medications suddenly necessary.

You can get Part D benefits within one convenient healthcare plan. If you’d rather manage only one Medicare plan, look into Medicare Advantage. These plans roll Original Medicare, Part D prescription coverage, and sometimes other benefits such as dental and vision into one convenient plan.

Give us a call to discuss your Part D plan options, and we can help you locate the type of plans that work best for your situation.


Posted by PGIA
2 years ago / February 23, 2022

Filed Under: Medicare Info