Medicare Part D: Beyond the Lowest Price - Choosing the Right Plan

Medicare Part D is a federal program that helps pay for the cost of approved prescription drug plans. Since Part D plans have significant differences in costs and coverage, factors other than the monthly premium should be considered when selecting a plan.

Coverage

• Coverage of medications varies between different Part D programs. The lowest price plan may not cover your all of your medications, which could lead to high out of pocket spending to obtain the medications.

Co-pays

• Even if a certain medication is covered, the co-pay may vary between different plans. If a brand name drug is required, it may require a significantly higher co-pay or not be covered at all by the plan with the lowest monthly premium.

Pharmacy

• Part D plans require the use of in-network pharmacies. Different plans consider different pharmacies in-network, so make sure your current pharmacy or a nearby pharmacy is in-network prior to selecting the plan.

Sponsor

• Be aware of the reputation and history of the Part D plan's sponsor prior to enrolling in the plan. The plan with the lowest monthly premium may be provided by a company with a relatively poor reputation compared to others or may have a history of making significant changes to plans on a yearly basis.

Off-label Use

• Some Part D programs do not cover certain medications unless a particular medical condition is present. If you are taking a medication that is prescribed "off-label," which means for a condition that it is not FDA-approved to treat, contact the plan's administration to ensure the medication is covered.