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How do I compare Medicare private drug plans? Question 6 of 9 (use "Last" or "Next" buttons to see more) Last Update: April 28, 2008
Before you start looking at plans:
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 private health plan (such as an HMO or PPO): Generally, you must get Part D drug coverage as part of your private health plan's benefits package. (If you join a Medicare Medical Savings Accounts (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! Here are some questions to ask.
Covered drugs:
- Does the plan cover all the medications I am taking?
- Does the plan cover the most important medications I take? (Ask your doctor.)
- 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)?
Cost:
- 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 in monthly premiums and annual deductible?
- Will I have to pay the full cost of my drugs at some point after the deductible (coverage gap)?
Pharmacy network:
- 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 work with my current drug coverage?
Get information about Medicare drug plans by searching Medicare.gov (click on the link in the LINKS box), calling 800-MEDICARE, or calling the plans directly.
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