MHI – Q: Wouldn’t the Part D plan with the lowest premium be the least expensive plan for me?

Posted by MedEd at MHI
A: Unless you take no medications at all, there is a good chance the plan with the lowest monthly premium is not the least expensive drug plan for you.

Let’s think about this for a minute. You really want to consider ALL the costs related to your plan, don’t you? The premium is only one of the three costs associated with most insurance policies. Does your plan have a deductible? Most (but not all) Part D plans have deductibles. The maximum allowable deductible in 2019 is $415.

You’re probably used to paying something for your prescriptions when you pick them up at the pharmacy. Once you satisfy your deductible (if there is one), the plan pays their share and then, you pay your share. Your share is referred to as your copay.

In order to compare the total out-of-pocket costs of different insurance policies, you’ll want to include 12 months of premiums, the annual deductible and 12 months of copays. The total of these three costs is your annual out-of-pocket cost, also known as your estimated annual drug cost.

The estimated annual cost is the term used by the Plan Finder tool on Medicare’s official website www.medicare.gov. This is the comparison tool of choice for anyone comparison shopping all the drug plans currently available in their state. Once your medications, zip code and preferred pharmacy are entered into the system, you will receive a list of the top ten plans in your state sorted in order of lowest to highest estimated annual cost. Use this as a starting point. Then look at quality ratings, drug restrictions and whether or not preferred pricing is available at your pharmacy.

Back to those of you who take no medications at all – you don’t have to take the deductible and copays into consideration because you aren’t taking any medications. The plan with the lowest monthly premium might not be a bad choice for you after all.

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