Help, I am trying to select a new Medicare Part D Plan and I need help!  How do you choose a Medicare Part D plan?

This question is being asked by almost everyone who is faced, either for the first time or once again, with evaluating their prescription drug needs and their Medicare Part D plan.

The most affordable coverage
Finding the "right" Medicare Part D plan primarily means finding the Medicare Part D plan that most cost effectively covers your medication needs.  In other words, probably the "best" Medicare Part D Plan is the Part D plan that provides the most affordable prescription drug coverage and is naturally also the Part D plan accepted at your favorite Pharmacies.

Pharmacies: How important is the availability of a participating or a preferred network Pharmacy?
Most national Medicare Part D plans have in excess of 40,000 to 50,000 participating pharmacies that accept their Medicare Part D plan and many have a mail order (and quantity discount) option.  The list of participating pharmacies is constantly growing and you can even ask your non-participating local pharmacist to join in and participate with your chosen Part D plan.  Most insurance carriers have a relatively easy process that allows a local Pharmacy to participate in a Part D plans coverage.  Therefore, unless you are located in very remote area, most Part D plans can be used in your area and Pharmacy selection is not a major issue.

However, most Medicare prescription drug plans also use preferred network pharmacy pricing - this means you may pay less at a preferred network pharmacy as compared to a standard (or non-preferred) pharmacy.

How much of a cost difference might you pay?
The chart below shows the variation between preferred and “non-preferred” network pharmacies for the 2016 California First Health Value Plus plan:


Note: The preferred and network pharmacy cost-sharing on the First Health Part D Value Plus plan varies by state. You can use our Rx$ icon on our PDP-Finder or MA-Finder to see the cost-sharing details for all tiers and pharmacies for any Medicare Part D or Medicare Advantage plan with prescription drug coverage.

Please note, some people choose a Medicare Part D plan for other reasons - aside from economics.
We have heard from many people who are enrolling in a Medicare Part D plan because they trust a certain insurance company and know they can rely on this company.  Some married couples, friends, or even relatives choose the same Medicare Part D plan carrier because they want to have identical statements and follow the same Part D plan procedures so that they can support one another.  As noted, some people are only interested in purchasing 90 day quantities and/or use Mail Order to further reduce monthly costs.

No Meds? Lower Premium plans with large formularies may be better.
Some Medicare Beneficiaries are able to simply enroll in a Medicare Part D plan with the lowest cost premiums because their medication needs are low or non existent – that is, they simply do not need Part D coverage, but they wish to avoid the possible premium penalties.

Extremely High Medication Costs? Lower premium Medicare plans may also be better.
If you are a Medicare Beneficiary with very high Medication costs, you may also be able to enroll in the lowest cost Medicare Part D plan that covers your medication and not worry about paying extra premiums for the coverage in the Coverage Gap.

How can this work?
If you have retail costs of Medications, for example, totaling $800 - you will go into and out of the Coverage Gap very quickly and will spend the majority of the year in the Catastrophic Coverage phase of your plan where your costs will be reduced to $2.15 for generics and $5.35 for Brand Name drugs – the key is to ensure that your medications are covered by your chosen Medicare Part D plan.  Still need to be convinced?  Take a look at a real a example:  https://q1medicare.com/PartD-DoINeedCoverageInTheDonutHoleGap.php

Who can help?
Medicare has provided a series of online tools to help aid your plan selection and they also offer telephone assistance (1800-Medicare or TTY 1-877-486-2048).  Aside from the federal government, you can also find help with local Churches, State Agencies, and Senior Groups.