Before you start looking at plans:
- Make a list of the medicines you take and how much you currently pay for them. You may want to ask your doctor for help.
- Make note of pharmacies you use regularly.
There are two types of drug plans you can choose from depending on how you get your Medicare benefits. If you have:
- Original Medicare: Choose a stand-alone prescription drug plan (PDP) if you want to continue to receive your other health benefits through Original Medicare.
- A Medicare Advantage Plan (such as an HMO or PPO): Generally, you must get Part D drug coverage as part of your Medicare Advantage Plan’s benefits package. (If you join a Medicare Medical Savings Account (MSA), Private Fee-for-Service (PFFS) plan without drug coverage, or a Cost Plan, you can also join a PDP.)
Get the facts before you enroll in a plan. Below are some questions to ask.
- Does the plan cover all the medications I am taking?
- If the plan does not cover a medication I take, does it cover one that will work for me? (Ask your doctor.)
- Does the plan require that I get special permission before it will cover the medication I need (such as prior authorization or step therapy)?
- How much will I pay at the pharmacy (copayments or coinsurance) for each drug I need? (Certain drugs may have high coinsurance.)
- If a drug I take has a very high coinsurance, is there a drug I can take that will cost me less? (Ask your doctor.)
- How much will I pay for monthly premiums and the annual deductible?
- Can I fill my prescriptions at the pharmacies I use regularly?
- Can I fill my prescriptions when I travel?
- What happens if I go to pharmacies that are not in the network?
- Can I get prescriptions by mail order?
Coordinating with your other benefits:
- Will the Medicare drug plan I am considering work with other coverage I have?