Your Part D Coverage Should Meet Your Prescription Needs
Like all health insurance, you want a plan that provides the benefits and coverage you need. With Part D specifically, you need to make sure the prescriptions you use on a regular basis, as well as potential prescriptions you may want in the future.
Different plans will include different coverage, something that likely does not come across as much of a surprise. Sometimes, plans can be customized to meet your specific needs, especially if you’re looking for specialty drugs.
Keep in mind that, if you have a chronic special needs plan (C-SNP) or a dual-eligible special needs plan (D-SNP) you should receive Part D coverage that meets your exact prescription needs.
Make Sure It’s Within Budget
If you do not qualify for a C-SNP or D-SNP, you’ll also want to make sure you can afford the coverage you’re purchasing. Pay close attention to the prescriptions you’ll need—once again, you want to make sure they’re included.
But, not only that, you will also want to make sure you’re not paying for more coverage than you actually need. Drugs are categorized by type in relation to price. These 5 categories, or tiers, start at the least expensive at $1-$3 coinsurance, to the most expensive at a 25% to 33% copayment. Try to find a plan that falls on the lower end of those coinsurance and copayment spectrums.
Part D Limits Based On Location
You are also limited to providers that are available in your area. Some states enforce certain restrictions or give certain parameters for insurance companies to follow, so be sure to know what your state allows.
This goes hand-in-hand with the drugs you need—if what you need is more expensive in your area, you will want to be certain that it will be included in any potential plans.
Work with a Talented Agent
Agents are one of the best and easiest ways to shop for Medicare Part D coverage. When looking for a plan, it is up to you to compare available options and negotiate coverage with available companies. Not only do you have to choose between providers, but you also have to navigate the enrollment process itself, which can be tricky for many, especially those who are new to Medicare.
An agent—a good agent—will walk you through this entire process, and take care of almost all of this legwork for you. All you have to do is tell them the coverage you want and you budget, and they will find a plan that fits your budget and is available in your area.