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Medicare Part D Insurance Comparisons

Part D is the prescription drug plan offered by Medicare, the health insurance program available to the elderly and disabled in the United States. It was created in 2003 as a part of the Medicare Modernization Act and coverage began in 2006. Part D plans are offered by private health insurance plans and plans vary by region. Comparing plans is a way for consumers to ensure they are getting the most out of their Medicare benefits.

  1. PD or MA-PD?

    • When comparing Part D plans, consumers should keep in mind the pros and cons of stand-alone Part D plans that work with traditional Medicare, or PD plans, and Part D plans that are packaged with Medicare private health plans, MA-PD plans, also known as Medicare Advantage. If they would rather receive their benefits from a private health plan, then they should shop for a Medicare Advantage plan exclusively since they are almost always packaged with a Part D plan.

    Coverage

    • One of the most important points of comparison for Part D plans is prescription coverage and/or restrictions, which may require prior authorization; step therapy, the use of other drugs first; and quantity limits.

      Other concerns are whether the consumer’s preferred pharmacy is considered in-network and whether the consumer otherwise has access to in-network pharmacies.

    Costs

    • It is also important to make sure the consumer’s required drugs are affordable. Prescription insurance plans often separate their drugs into cost tiers, which may vary from company to company. While a consumer’s drug may be in a low cost-tier for one plan, it may be triple the price in another plan.

      Other elements to be considered when comparing Part D plans are premiums, deductibles and availability of assistance during the Part D coverage gap (the period when the plan stops paying for drugs).

    Coordination

    • A consumer who has drug coverage from something like a retiree plan should contact the current plan administrator to learn how it will work with Part D. Consumers may lose their retiree drug coverage if they purchase a Part D drug plan.

    Enrollment

    • Enrolling in Part D is optional for Medicare enrollees. If they choose to enroll, there are only certain times of the year they may do so. They may sign up for Part D when they first become eligible, the initial enrollment period. They may also sign up during the annual coordinated election period, which lasts from Nov. 15 to Dec. 31 each year, or—if they qualify—during a special enrollment period.

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