Best Medicare Part D Plans
Finding a Medicare Part D Prescription Drug Plan
There are certain words we kept coming across as we researched Medicare Part D: “maze,” “variables,” “many moving parts.” Like any other system in which government agencies and private enterprise are intertwined, it’s complicated. Plus, factors such as location, age, prescriptions and preferred pharmacies often affect your choices.
Since 2014, we've provided detailed guides to companies that offer Medicare Part D plans and websites geared toward directing you to the best Part D plan in your area. When choosing your prescription drug coverage, you don’t want to wind up hurting both your health and your wallet. Below you'll find some advice, tools and professionals that can help you navigate the process.
Best Place to Begin: The Medicare Plan Finder
Believe it or not, the federal government built some pretty useful software for this program, and the Plan Finder is the best place to begin, according to Leigh Purvis, director of Health Services Research at the AARP Public Policy Institute.
The Plan Finder “allows you to input broad or individualized (e.g., which drugs you are currently taking) information that can then be used to evaluate the Part D plans that are available in your area,” Purvis says.
In addition to costs and formularies, the Plan Finder includes star ratings, which are determined by surveying customers and health care providers, as well as other factors such as reasons customers leave the plans and patient compliance.
“The government has really put a lot of effort into data collection [for the star ratings],” says Diane Omdahl, president and cofounder of 65 Incorporated, a Medicare consulting company. “The problem is, when you look at the star ratings, there are a lot [to read through]. The ones that we zero in on are drug plan customer service, members’ rating and members’ experience with plan.”
Starting to feel overwhelmed? Then it’s time to turn to one of these other resources.
Best for Free, Unbiased Advice: SHIPs
State Health Insurance Assistance Programs are federally funded, state-managed centers that provide free counseling about Medicare over the phone or in person. The staff and volunteer experts in the programs use the same Plan Finder as you would on your own, but they’ve undergone extensive training and have experience navigating through the challenges these choices present.
“We ask [consumers] questions to try to help them decide,” says Ray Walker, divisional director for the Medicare Assistance Program (a SHIP) at the Oklahoma Insurance Department. “What is the most important thing to you: Having a short drive to the pharmacy? Is mobility an issue for you? [Is the priority] the copay structure for this particular medication?”
Though SHIP counselors are not allowed to recommend one specific plan, by asking these questions and evaluating which plans’ formularies best suit a person’s needs, they’re able to narrow down the choices significantly. Walker estimates that consumers who follow his staff’s advice save an average of $2,100 a year. And since the services are free, you can call your state’s SHIP any time throughout the year, especially during every open enrollment period, when you need to decide whether to keep your current plan or switch to a new one.
“We always recommend SHIPs as a resource for people who want more-personalized help with sorting through their Medicare plan options,” Purvis says.
You can find your state’s SHIP website in this drop-down menu.
Best for Free, Laser-Focused Advice: Licensed Insurance Agents
Brokers have a lot of training and expertise under their belt, and a good one will be able to spend quality time looking at your individual needs at no cost to you. Be aware, though, aware that most agents work on commission and are in business to sell plans for the companies that will be paying them. One way to make sure you’re dealing with someone who has your best interests in mind is to go to an agent who represents a number of insurance companies.
“Ask them: ‘Do you sell all the plans that are available, or do you only represent certain companies?’” Walker advises.
Best for Unbiased Hand-holding: Flat-Fee Medicare Consultants
“It makes sense to me,” is how Diane Omdahl describes her Medicare expertise and resultant understanding of the enrollment process. Omdahl, cofounder and president of 65 Incorporated, is a registered nurse and directed a skilled nursing facility before getting into the Medicare advice business. Services such as 65 Incorporated, Allsup Medicare Advisor, Health Care Navigation and others you can find in your area charge a fee for one-on-one consulting. It’s not cheap; 65 Incorporated charges $399 to walk you through your initial enrollment. The advantage is that because these consultants do not work on commission, they have no ulterior motive to steer you to a particular company or a more expensive product.
Considering how much you might have to pay out of pocket for an uncovered medication if you choose the wrong plan, it may be worth your time – and possibly some of your money – to get a helping hand with the process.