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Finding the right Medicare Part D

Prescription Drug Plan

Determining which Medicare Part D Prescription Drug plan is the best option for you can only be done after you thoroughly examine all the plan options available in Illinois.

The Medicare Part D program is standardized. Medicare contracted insurance carriers must meet Medicare’s minimum requirements to offer plans but there are some substantial differences within the plans. Some plans have different deductible and copayment structures as well as formularies. For example, one insurance carrier might offer extremely affordable prices on a particular medication that is not even covered by the Part D plan of another carrier.

So what parameters should you consider when looking for a plan? There are four basic variables – insurance carrier, premium, copayment/deductible costs and formulary.

  • Insurance Carrier – Identify three to four insurance carriers that offer a Part D drug plan as well as a ones that you have heard of, have experience with and trust.
  • Premiums – Most plans carry a monthly premium to be enrolled, so choose one you are comfortable with but keep in mind that the premium might not necessarily correlate with your needs. The more it costs doesn’t mean it is better. Just as the lowest cost plan might not have what you need.
  • Copayment/Deductible – Each drug tier has a different copayment structure. For example, a Tier 1 Generic may carry a monthly prescription copayment of $10 with one insurance carrier’s plan and a copayment of $15 with another. However, other plans may carry a deductible that you must first meet before you start to pay the copayment amounts.
  • Formulary – The formulary is the list of medications that are covered by that insurance carrier’s plan. One medication might be covered under one insurance carrier’s plan formulary but not covered by another insurance carrier’s plan. It is important that your medication be covered.

Take your time and thoroughly examine all your options or contact a licensed insurance specialist that is trained and certified with Medicare Part D. Healthcare Services of Illinois’ (HSOI) licensed insurance specialists are Medicare Part D trained and certified and regularly guide its clients through the Medicare maze ensuring that they understand their options, cost structure, coverage and find the most appropriate plan.