I have Original Medicare and a Part D plan. I’m considering changing my Part D plan this Medicare Open Enrollment Period. How can I compare Part D plans?
-Mina (Walla Walla, WA)
I’m glad to hear you’re comparing your Medicare coverage options this fall! Research shows that many people with Part D could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions or with lower costs, so it’s great that you are trying to compare plans.
I would recommend using Plan Finder to compare Part D plans. Medicare Plan Finder is an online tool at www.medicare.gov that can be used to compare stand-alone Part D plans or Medicare Advantage Plans. Plan Finder provides information about costs, which drugs are included on the plan’s formulary (list of covered drugs), and the star rating of the plan.
To use Plan Finder, follow these steps:
- Go to medicare.gov and click on the button that says, “Find Plans Now.”
- You can do a general search on the right side of the page, under the title “Continue without logging in” button. If you wish to save your drugs and pharmacy information, you can log into or create your Medicare account on the left side of the page.
- Next, put in your zip code and use the drop-down list to choose whether you are looking for a Medicare Advantage or Part D plan. Make sure you click “Apply” and then click on “Start” to begin your search.
- Then you can enter the drugs you take, choose the pharmacies you use, and indicate whether you are interested in a mail order option.
Plan Finder will display results for plans in your area. Note that a plan may not cover all of the drugs you take, but it may have alternatives on its formulary. Speak to your provider about whether these alternatives would be appropriate for you. Plan Finder also tells you if the plan has a deductible and how much the monthly premium is.
Initially, the plans will be sorted by “lowest drug + premium costs.” This is the closest estimate to what you may pay out of pocket for your Part D coverage for the year. You can select “Plan Details” to find out more specifics about coverage, including any coverage restrictions that might apply to your drugs.
Before enrolling, it is a good idea to call the plan directly to confirm any information you read on Plan Finder, as information may not be completely up to date. Here is a list of questions you can ask when calling a company about their prescription drug coverage. You can enroll in a plan online, by calling 1-800-MEDICARE, or by calling the plan directly.
Note that this year, there are some additional things that people who take insulin should consider when using the Plan Finder tool. Beginning in 2023, cost-sharing for insulin is capped at $35 per prescription. However, the Plan Finder tool does not reflect this price change. If you take insulin, do your Plan Finder search without your insulin included in your drug list. This will show you the lowest cost plans for your other medications. Then separately check with a plan to see if your insulin is on the plan’s formulary.
You can make as many changes as you want between October 15 and December 7, but only the last change you make will take effect on January 1. If you choose a plan and realize that it is the wrong plan after Fall Open Enrollment is over, in most cases you will not be able to change your coverage until the next Fall Open Enrollment Period. For this reason, it is important to carefully consider all of your options and take the time to research each plan in order to make a decision that fits your health care needs.
Good luck choosing the best Part D plan for your needs!