How do I shop and compare Part D Rx Prescription plans?
If you want us to shop for you... Send [email protected] a copy of your Medicare ID card.
BE CAREFUL OF THE SNAFU'S!!!
The “Total Yearly Cost of Care” does not provide personalized or transparent information. For example, when a consumer inputs or changes personal data, such as drug information, his or her total estimated costs do not change. This is not mathematically possible based on the plan benefits. Additionally, the tool does not share what is included in the total cost. As a result consumers will likely see the total cost and assume they are receiving a personalized and tailored estimate which may not be accurate.
The estimated total yearly cost of care is flawed. On a plan that has reduced benefits year over year, the expectation would be that the “estimated total yearly costs” would increase. However the tool is inaccurately estimating the consumer’s costs will decrease. It doesn’t make mathematical sense. For consumers on a fixed income and cost conscious, this could be detrimental to their situation.
Most supplemental benefits are not included in the total yearly cost of care. Over the past several years supplemental benefits have expanded and provided members with options that not only treat, but prevent illness and increase quality of life. We know the high value of benefits such as vision, dental and hearing to our consumers, and they are a key way we are partners in care with our members. Some of the benefits that are not included are:
Transportation lists copay but not number of rides.
Eyeglasses list copay but does not share if benefit covers frames, lenses or contacts.
Wellness Programs include a long list of possible items including fitness, nurse hotline, Personal Emergency Response and telehealth, that can’t be lumped into a single “covered” or “not covered” benefit. Excerpt from UHC Agent Memo * Forbes * GAO 7.2019 Report *
- Blue Cross Learning & Enrollment Portal
- Blue Shield Learning & Enrollment Portal
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.
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
for Shopping Tool
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%).
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.
The prescribed strength or amount of therapeutic ingredient(s) administered at prescribed intervals.
This tells you that a plan offers coverage of prescription drugs.
The plan may have certain coverage restrictions (including quantity limits, prior authorization, and step therapy) on a prescription drug.
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.
A list of prescription drugs covered by a prescription drug plan offering prescription drug benefits.
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.
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 *
My Drug List
No longer relevant – One needs to have an ONLINE Medicare Account to use the NEW Part D Rx Finder.
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.