UNITED STATES—Toni: I am turning 65 in July and am an insulin dependent diabetic. I take 2 insulins which are rather expensive. I am concerned about the Part D Donut Hole because I’ve seen my husband struggle with his current choice.
Last year, my husband Steve changed from his Medicare Supplement Plan with a separate Part D plan to a Medicare Advantage PPO plan. He was told that his doctors were in the plan and all of my husband’s heart meds were covered. Which was not true!
He is now taking Xarelto for his heart and dives right into the Donut Hole. My question is how do I know which is the right Medicare Part D plan for me? Please guide me to find the best plan to fits my prescription drug needs and not financially break me. Thanks, Margie from San Antonio, TX.
Great question, Margie: The first topic discussed at a Medicare consultation in the Toni Says® office is which Medicare Part D prescription drug plan or plans cover all your prescriptions. Most do not realize that all medications are not covered under Medicare Part D formularies. When not covered, one must pay 100 percent out of pocket.
Searching for the right Medicare Part D prescription drug plan that fits your needs is vital to proper Medicare planning.
Steps to do your own Medicare Part D prescriptions drug planning and find which plan best fits your prescription drug needs are below:
1) Go to Medicare.gov
2) Click on the first green box which says “Find health & drug plan
3) Put in your zip code and click “Find Plan” box.
4) Step 1 of 4: Enter Information: fill in 2 boxes that says Box #1 says…I don’t know what coverage I have. Box #2 says…I don’t know…Box #3…Yes
5) Step 2 of 4: Enter Your Drugs
6) Step 3 of 4: Select Your Pharmacies…you can select only 2 pharmacies.
7) Step 4 of 4 Redefine Your Plan…for prescription drug plan only check first box. For MAPD click what Medicare Advantage Plan best fits your Medicare Prescription Drug needs. You can check both or all 3 boxes if you like.
8) Finally, Your Plan Results…click on the first boxes (maximum of 3). Chose the first box and then pick 2 more and make sure that you have chosen one with the Part D deductible and one which is enhanced with no deductible.
9) View Your Plan Comparison…it will tell you the monthly premium, deductible, costs and if all drugs are covered on the plan you have picked.
10) Under section saying, “Monthly Drug costs at Retail Pharmacy…your monthly costs and if or when you go into the donut hole or into catastrophic coverage will appear.
11) Click on “View Drug Cost Summary” this section tells the pharmacy price for each prescription with also co-pay and cost when in coverage gap and catastrophic coverage.
12) Pick which Medicare Part D plan best fits your needs, covers your prescriptions and the pharmacy that you like is included.
Congratulations…. you know how to find your own Medicare Part D plan!!
If you are still confused and would like to discuss your specific Medicare circumstances email firstname.lastname@example.org and the Toni Says® team can help you.
Toni King, author of the Medicare Survival Guide® Advanced is giving a $5 discount on the Medicare Survival Guide® Advanced book and bundle packages as a Thank You for the Toni Says® newspaper article readers. Go to www.tonisays.com to purchase.