How do I shop and compare Part D Rx Prescription plans?

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The four  main tools to shop and compare Medicare Part D Rx plans are:

See below for more details on how to work the tools.  If you prefer, you can email us [email protected] your medication list and we can do the comparisons for you.

Here’s the results of a hypothetical person with diabetes taking 8 medications.

Medicare.gov shows that the cost,  without any Part D coverage would be $17k.  If this person signed up for the Blue Shield Plan  their annual costs, including the Part D premium would be $8k.

If you are low income you might check out LIS – Low Income Subsidy – Extra Help to pay the Rx costs that are not covered.  LIS may also pay your Part D and Part B premiums and you might also qualify for Medi-Cal.

Scroll down to the glossary for definitions.

Medicare.Gov Glossary
for Shopping Tool 

Coinsurance

An amount you may be required to pay as your share of the cost for health care services or prescriptions after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).

Deductible

The amount you must pay for health care services or prescriptions each year, before your Medicare drug plan, your Medicare Health Plan, or your other insurance begins to pay. These amounts can change every year.

Dosage

The prescribed strength or amount of therapeutic ingredient(s) administered at prescribed intervals.

Drug Coverage

This tells you that a plan offers coverage of prescription drugs.

Drug Restrictions

The plan may have certain coverage restrictions (including quantity limits, prior authorization, and step therapy) on a prescription drug.

Example of Restrictions
Example of Restrictions

Estimated Annual Drug Costs

This is an estimate of the average amount you might expect to pay each year for your prescription drug coverage. This estimate includes the following costs, as applicable:

  • Monthly premiums
  • Annual deductible
  • Drug copayments/coinsurance
  • Drug costs not covered by prescription drug insurance

If you entered your drugs into the Medicare Plan Finder, then this estimate includes the cost of those drugs.

If you selected "I don’t take any drugs," then this amount includes only the cost of the monthly premiums that you would pay for the plan and it does not include any drug costs.

If you selected "I don’t want to add drugs now," then this estimate includes the average drug costs for people with Medicare and may differ depending on your age and health status.

Your expenses may be lower if you have limited income and resources.

Formulary

A list of prescription drugs covered by a prescription drug plan offering prescription drug benefits.

Monthly Premium

The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage. In a few cases, a note will say "Under Review" instead of a premium amount. This means Medicare and the company are still discussing the amount.

MTM Program

Medication Therapy Management (MTM) Programs offer free services to eligible members of Medicare drug plans. These services help make sure that medications are working to improve their members' health. Members can talk with a pharmacist or other health professional and find out how to get the most benefit from their medications. Members can ask questions about costs, drug reactions, or other problems. Each member gets their own action plan and medication list after the discussion. These can be shared with their doctors or other health care providers. Members who take different medications for more than one health condition may contact their drug plan to see if they're eligible.

Star Ratings – Medicare Advantage

Medicare Glossary
Medicare Glossary

My Drug List

The list of your prescription drugs previously entered on the site to help generate better estimates of annual and monthly costs under the available plans, and also see which plans cover your drugs.

The site doesn’t show pricing for over the counter drugs or diabetic supplies (e.g. test strips, lancets, needles). For more information, you may contact the plan.

Medicare Part D - Retrieval Code - Send us this # and we can review the results with you

Medicare Part D – Retrieval Code –
Send us   this # and we can review the results with you

Search and see if your drugs are covered & enroll.

If you want us to enter your Rx, we need this kind of detail.

We get a referral fee when you use Health Compare.com and are not your agent. Check with us if we represent the plan you want.  We get NOTHING if you sign up directly with an Insurance Company or if you use Medicare.gov

Medicare.Gov
Video’s on how to use their website for your Rx Search & Comparison

There are 5 Medicare Plan Finder lessons that provide a step by step overview on how to complete a plan search, compare plans, and enroll in one that best meets your needs.

Lesson 1 (of 5) will cover the importance of having certain information at hand before you begin a plan search, and things to consider when using the Medicare Plan Finder

medicare.enrollment

Publication 11036 28 Pages

Official Medicare Guide to choosing a Medi Gap Policy # 02110
Official Medicare Guide to choosing a Medi Gap Policy # 02110

Medicare and You 2019 - Everything you want to knowMedicare and You 2019 #10050 - Everything you want to know * See their section on closing the donut hole

4 comments on “Shop & Compare Tools Part D Rx

  1. I would like to know what the cost of tier 1 medications are.

    Specifically lisinopril hydrochlorothiazide and Atorvastatin.

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