When you are choosing among Part D plans, here are some questions to keep in mind. Before you start looking at plans, make sure you know:
- The prescriptions you take, including their dosages and usual costs (you may want to ask your doctor for help creating a list)
- The pharmacies you regularly use
- Are my prescriptions on the plan’s formulary?
- Does the plan impose any coverage restrictions, such as prior authorization or step therapy?
- If the plan does not cover a medication I take, does it cover one that will work for me? (Ask your doctor.)
- How much will I pay at the pharmacy (copayments or coinsurance) for each drug I need?
- How much will I pay for monthly premiums and the annual deductible?
- How much will I have to pay for brand-name drugs? How much for generic drugs?
- What will I pay for my drugs during the coverage gap?
- If a drug I take has a very high coinsurance, is there a drug I can take that will cost less? (Ask your doctor.)
- Am I eligible for Extra Help or a State Pharmaceutical Assistance Program (SPAP)?
- What is the service area for the plan?
- Can I fill my prescriptions at the pharmacies I use regularly?
- Can I fill my prescriptions when I travel?
- What will my coverage options and costs be if I visit out-of-network pharmacies?
- Can I get prescriptions by mail order?
Coordination with other insurance
- Will Part D work with other coverage I have to lower my costs?
- Do I need to enroll in Part D if I have other creditable coverage?
- Do I need to enroll in Part D if I have job-based drug coverage?