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How to Choose a Medicare Drug Plan

The patient reads the statements on the packaging of the drug at the pharmacy. A senior man with a smile in an elegant suit holds a package of medical drugs and reads the statement and expiration date while considering how to choose a Medicare drug plan.

Many people come to us looking for support on how to choose a drug plan that works for them. There can easily be 20-30 drug plans available in a given county. You have important questions like:

  • How will I know all of my medications are covered?
  • Is my pharmacy covered?

Here I will break down our method and what we look out for when helping someone choose a plan. 

My big secret…Medicare.gov. 

Honestly, I think the Medicare.gov drug plan finder does a great job for what it’s designed to do. I can’t say it does as well for Medicare Advantage and Supplement plans, but it’s great for drug plans. We often give the government a hard time about being inefficient and invaluable for solutions. Yet, whoever they hired for the drug plan finder did a great job. So, here is our method. 

Go to www.medicare.gov. Click the green “Find Health & Drug Plans” button towards the top.

Enter your zip code in the basic search section

Select Original Medicare, if you have Medi-Cal or not, and if you want to enter drugs.

Enter your drug information.

Select a pharmacy or two that you use.

Select Prescription Drug Plans and then click “Continue To Plan Results.”

All plans are show in order of lowest annual cost. Click a name for details.

Details page shows monthly costs overall, individually, and breaks down if and when you’ll enter the donut hole.

If you’re not familiar or comfortable with the internet this process may seem a bit involved. We often help people navigate and enroll in the option that they find best. Now, this is assuming you just want to find and enroll into a Medicare Prescription Drug Plan. If you are interested in exploring your options with other forms of coverage, such as Medicare Advantage, then this may not answer all your questions. At this point you may want to contact an agent and have them research what Advantage plans your doctors accept and what the drug coverage is with those so you can compare both sides. 

Outside of finding a drug plan that fits your needs we often support people with the following:

  • Finding generic or brand alternatives to medications not covered on a plan.
    • Sometimes a plan may not cover your brand or drug or there may be a cheaper generic to help you save on costs. We can support by finding what alternative brand drug or generic is covered that is a similar or identical drug to your current one. 
  • Assessing whether to have a deductible or not. 
    • If you haven’t had a deductible you may be attracted to a plan with a low monthly premium but a high deductible. That first month could easily be your entire deductible and some copays totaling well over $500-600. Now, of course, your monthly cost drop real low after, but that first month may seem unmanageable and may cause financial strain for some.  Alternatively you may want to select a plan with no deductible at the cost of a slightly higher monthly cost for stability. 
  • Find local pharmacies that deliver. 
    • Surprisingly, many aren’t aware that there often exists a local private pharmacy that will deliver your medications right to your door. This is not only convenient for you but can help give independence for those who can’t drive or walk to their pharmacy. You’ll never have to miss a day or two of taking medications due to not having a ride. 

With this information you can find and navigate your options as good as the pros. It never hurts to have one check your work though. In matters of health it’s better to “measure twice and cut once” by having someone trained and experienced to review your research and give you peace of mind that things go as planned when you visit the pharmacy for the first time with your new drug card.

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