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

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  for definitions and instructions to use the Rx Plan Finder

Medicare and You 2020 #10050  
Everything you want to know 

Medicare and you

Different Parts of Medicare 

A = Hospital
B = Doctor Visits - Out Patient
C = Medicare Advantage or Medi Gap
D = Part D Rx 

Video

Understanding your Medicare Choices
Medi Gap vs Medicare Advantage

Topics

How to sign up for Parts A & B
Is  your test, service, or item covered?
Original Medicare Parts A & B
Medicare Advantage Plans & Part D Rx
Supplement Insurance (Medigap)
Low Income Help  LIS
Definitions


Don't like computers?
Prefer a printed version be mailed to you?
Audio MP 3  

Use our scheduler to Set a phone, Skype or Face to Face meeting
Intake Form - We can better prepare for the meeting

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

dosage shop and compare

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

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.  Humana * Medicare.gov

Star Ratings – Medicare Advantage

Medicare Glossary
Medicare Glossary

5 comments on “Shop & Compare Tools Part D Rx

  1. Medicare‘s plan finder is being upgraded

    https://www.cms.gov/newsroom/press-releases/medicare-plan-finder-gets-upgrade-first-time-decade
    https://www.modernhealthcare.com/medicare/cms-refreshes-much-used-medicare-plan-finder-tool

    The changes include an improved mobile-friendly design

    inform users if a generic version of their prescription drug is available

    Users can also create a personalized drug list and view drug coverage across Medicare Part D plans. If someone is already a Medicare recipient, their recent claims data will be used to prefill a personalized drug list that they can modify based on recent changes in their medical care.

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

    Specifically lisinopril hydrochlorothiazide and Atorvastatin.

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