Help with Medicare Plan Finder
Q: You’ve mentioned that the Medicare Plan Finder tool at Medicare.gov is a great way to compare Medicare Part D plans, but the tool seems difficult to use. Do you have any tips for navigating this online resource?
A: Yes, the Plan Finder tool at Medicare.gov can be a bit complicated, but the tips below can make it easier to use.
Start at the Plan Finder main page (www.medicare.gov/find-a-plan), where you can personalize your search by entering your Medicare number, last name and other personal information (or you can just input your zip code for an anonymous search). Answer some basic questions about the type of Medicare plan you have now, such as traditional Medicare plus a supplemental (medigap) policy and a separate Part D prescription-drug policy, or an all-inclusive Medicare Advantage plan (called “Medicare Health Plans” in this tool). Then click on “yes” when it asks if you would like to add your drugs.
Enter the names of your medications, dosages and frequency. If there’s a generic alternative to a brand-name drug you have listed, a box will pop up giving you the option to include the lower-cost generic drug rather than the brand-name drug in your calculations.
Next, you’ll be given the option to select local pharmacies. This has become a very important step for comparing plans now that most of them have preferred pharmacies, which charge lower co-payments than other in-network pharmacies. The default is a list of the closest pharmacies to your zip code, but you can use the dropdown menu at the top to expand the list and show pharmacies that are farther away. You can click on up to two pharmacies here.
A summary page will appear listing the number of stand-alone Part D prescription-drug plans available in your area and the number of Medicare Health Plans with and without drug coverage.
You’ll be given several options in the left column to refine your search, such as capping the amount of your monthly premium or limiting your annual drug deductible. But it’s best to see the full list and then narrow your search when you can compare overall costs.
After you click on “prescription drug plans,” you’ll see a list of the Part D plans available in your area. The first column for each plan will list the estimated annual drug costs, which includes the premiums, any deductible and the co-payments for your specific drugs. This is generally the best way to compare plans.
The second column shows the monthly premium, and the third lists the deductibles and co-payments for each tier of medications. The fourth column explains any drug restrictions, such as medications that require prior authorization by a doctor. You’ll also see the plan’s overall star rating, which assesses coverage, complaints and customer service.
Check the boxes of up to three plans you’re interested in and then click “compare plans.” In most cases, you’ll want to look for the plan that has the lowest estimated annual costs at the pharmacies you plan to use.
If this still sounds too complicated for you to use this tool on your own, or if you’d like assistance with picking a plan, go to your State Health Insurance Assistance Program, which provides personalized help as well as seminars during open enrollment. Call Medicare at 800-633-4227 to find contacts or visit www.shiptacenter.org for local contacts.