How do I pick a plan?

Picking a Medicare Drug Plan is not easy. There are a lot of factors that determine which plan is best suited for each individual. 

There are two ways a Medicare beneficiary can get Part D coverage. 

1. By enrolling in an Individual Medicare Prescription Drug Plan (PDP)
2. Or by enrolling in a Medicare Advantage Plan with Prescription Drug coverage (MA-PD).

Click here for a quick reference guide to some of terms used by PDP(s)

PDP(s) are individual free-standing drug plans intended to provide prescription coverage for Beneficiaries who received their hospital and medical benefits from original Medicare, an employer, Union, Medicare Cost Plan, or Medicare Private-Fee-for-Service without prescription drug coverage.

MA-PD(s) are Medicare approved health plans that combine a beneficiary’s hospital, medical, and prescription drug coverage all into one plan.

Please click here to receive more information regarding MA-PD(s)

After a beneficiary decides how he/she wants to receive the prescription drug coverage, either with a PDP or MA-PD, the steps involved in picking a plan are very similar.

First, you makes a list of the medications you are taking, the dose or strength of each, and how often (how many times a day) you take each medication.

After you make the list, decide what factors with your prescription coverage are important to you.   Here are some things to consider:

• Do you want a plan with or without deductible? Are you willing to pay a higher premium for increase benefits?
   
• Do you need a plan just for emergencies? If so you may want to go with a low premium plan that meets the creditable coverage requirement to avoid the Part D penalty and provides coverage if a person should need medications for other then maintenance reasons.
   
• Do you take multiple medications? If so, you will need to enroll in a plan that will provide you with the best overall coverage. A plan that will keep your “total annual drug Cost” at manageable amount. Find a plan that best balances the plan premium and cost of your medications.
  
  
• Do you take a lot of medications? Are many of them brand name medications? If so, look for a plan that covers as many of the brand name medications in their “preferred brand” tier. Also because you take a lot of brand name medications, is it necessary for you to have a plan that offers coverage in the coverage gap for your other or generic medications.
  
  
• Because you take a lot of medications, do you need a plan with a large formulary?
  
  
• Are your medications effected by and coverage limitations with certain PDP(s)?
  
  
• Do you travel a lot or spend a good part of the year in two or more locations? If so, you may want PDP that is recognized nationally. Not just in your home state.

Beacon Retiree Benefits Group can help you with these questions and more to find the plan that best suits your specific needs.  Please contact our office for further details: