Since it is Medicare open enrollment time I wanted to ask the TuDiabetes community to share your strategies to pick a Part D plan. Also a good time to remind everyone on Medicare to check the 2025 formulary for your current plan.
Personally I’m not on Medicare (yet) but this year my parents have asked for help checking their plan so I’m hoping to find some tips from those with experience.
- Register on medicare.gov
- Go to Part D drug Plans
- Make sure year is set to 2025 and enter your zip code and press continue
- Click on Medicare drug plan (Part D)
- Answer questions on do you get help page and press continue
- Click yes on: Do you want to see your drug costs when you compare plans?
- Add your prescription drugs
- Add five pharmacies (Do five as different prices at different pharmacies)
- Sort plans by lowest drug + premium cost
- Go to plan details to see all your costs
- Now you need to beat the high deductibles
- Go to discount cards such as:
- SingleCare - Best Prescription Drug Price Comparison.
- America’s Pharmacy - Most Versatile Prescription Discount Card.
- WellRx - Best Prescription Discount Card App.
- GoodRx Gold - Best Paid Prescription Discount Card.
Your doctor can only send your prescriptions electronically to one pharmacy.
Depending on the number of drugs you take, there will be a huge price difference between pharmacies, so remove any that are higher priced through your part D policy and buy them directly with your discount card(s). To do this, ask your doctor for a paper prescription for the drugs you will buy directly.
If you take a lot of drugs, you may want to buy everything through your Part D plan if what you would buy through your discount cards will cost annually more than $600 or so which will most likely be your deductible.
I just quickly typed this up, so if you have any confusion, ask away, and I will clarify.
Once you are done, it is not set and forget. My part D 2024 no longer insures in my State for 2025 so I am just starting this process again now as my current plan will expire at the end of 2024
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I think I’ve always chosen the lowest cost plan. I recommend for you to enter the drugs your parent takes and make notes on the plan or plans you think you like best. Then go back and add a good antibiotic you think your parent might need occaisionally. I want a plan that covers a good antibiotic. I searched for drug plans today and I didn’t think the site is as good as it has been in the past. I got some weird results. I will probably call Medicare another day with some questions. In previous years, I was given a breakdown of co-pays for each individual drug. I didn’t get that today. I got one individual co-pay for one drug.There were other things that didn’t make sense. It was truly wacky.
With Medicare, the reps are either great or horrible. If someone isn’t helpful, call back & hopefully, the next person will help. It can be time consuming. Budget a lot of wait time.
I don’t recommend a Humana plan. I’ve had bad experiences with them.
I take that back. I would enter 3 or 4 good antibiotics. Everyone needs access to good antibiotics. The reason I stress that is because my current insurance didn’t cover a very old generic antibiotic. Even my doctor was shocked by that. That drug is at least 50 years old.
I have used the State Health Insurance Benefits Advisor, SHIBA, many times to help me pick the best Medicare Part D plan for me. Since I’ve gotten better at using the Medicare.gov website, I will call my SHIBA phone number in my state to get an independent take on my selection.
SHIBA is staffed by trained volunteers in every state. Just do a google search on “SHIBA Medicare (your state)”. You may have to make an appointment to schedule your call.
This is an important decision with important financial consequences; it’s worth the effort. You have until December 7th to get this done!
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Medicare plan finder lists the plans cheapest first, do that makes your search easier
I am not sure what you are saying. If you follow the steps I outlined, then the plans that come up will be sorted by the default sort which is by Lowest drug + premium cost. There are drop-down boxes in the header where you can change the “filter by” and “sort plans by” options.
The filter by options allows you to filter by Insurance carrier and Insurance carrier star rating.
The Sort plans by options lets you change the default option to sort by the Lowest yearly drug deductible or the lowest monthly premium.
It is really useful to use the default option but then scroll through the plans and look at the costs, because these costs change based on which drugs you plan to have covered by the insurance company and which drugs you plan to buy using a pharmacy discount card. Alternatively, you could put only one drug at a time into the “add your prescription drug” form and then run the plans with the default setting to see which drug(s) are the most costly through the insurance plans and then look for the cheapest you can buy your expensive drugs by using pharmacy discount cards.
Janelle
This is great info, thank you. Are there reasons to choose a plan other than lowest cost?
Some plans may not have one or more of the drugs you use or may need in the future in their formulary causing you to drive farther to find an in network pharmacy that has that drug, in other words convenience. Some people are nervous going with a lower cost plan with a low star rating as those plans tend to have poorer customer service causing wasted time on the phone and frustrations when something goes worng with their drug, prescription or plan.