Best Medicare Part D Plans

When it comes to choosing the best Medicare Part D plans, "best" is a relative term. What works best for one person may not be the best for another. Coverage varies from region to region, and each company that offers a Medicare Part D or Medicare prescription coverage plan offers a range of prices and benefits. To choose the best plan, choose coverage based on your needs.

Coverage

• Medicare Part D plans cover prescription medications. The key to finding the best plan is to find the one that covers most, hopefully all, of the medications you are taking. Prepare a list of all of your current medications. Talk with your doctor about those medications and whether there are other medications in the same class that be substituted if necessary. Then compare your list of medications against the formularies that show what various plans cover. The official Medicare website has several tools that will help you find companies that cover your medications (see Formulary Finder below).

The Gap

• You will find there are a number of plans that include a period of time during which they will not cover medication costs, or only cover generic medications. This is commonly called "the gap," or sometimes "the doughnut hole." The point at which you reach the gap varies from plan to plan; most use a combination of how much you have spent out of pocket and how much they have paid. Once you are in the gap, you may pay for most or all of your medications out of pocket. How long you will remain in the gap varies; some plans have no gaps, others short-term ones, others longer-term ones. You usually have to spend a certain amount of money out of pocket before the gap ends. Generally speaking, the larger the gap, the less you pay for insurance up front; the smaller the gap, the more you should expect to pay for insurance up front.

Balancing Costs

• Before you choose a plan, do the math to figure how much you will pay for premiums, medication co-payments while you are covered, medication you must pay for while you are in the gap, and medications after your coverage resumes. You will quickly see that a lower premium may not be worth it if you spend more than you save during the gap. A policy with a higher initial premium may cost less in the long run if it pays for generics during the gap. At the same time, it does no good to choose a plan with premiums so high you cannot afford to pay them. The only way to know which policy is best is to do the math and look at the big picture. If you take the time to do this, then you will truly know which plan is best for you based on your needs and resources.

Customer Service

• Once you have determined which Medicare part D plan is best for you, contact the insurance company directly. How well your questions are answered will help you make your final decision. The best companies have agents and customer service representatives who will take the time to explain their policies and procedures to you. Bad customer service at this stage is a warning that you may receive bad customer service when you need it down the road. Before you make your final decision, inquire about appeal procedures. These procedures are a vital part of utilizing your plan to your best advantage. You should know how and where to appeal their decision if your company denies coverage for a particular medication. If they cannot simply explain to you how they handle this common and necessary procedure, then this company is not the best one for you.