Top Three Things to Consider When Deciding on a Part D Plan

Top Three Things to Consider When Deciding on a Part D Plan

Medicare Part D offers prescription drug coverage and is provided by private insurance companies. Part D is available as either a standalone plan that works with Medicare Part A and Part B or through a Medicare Advantage plan. Part D coverage and benefits vary depending on the company. 

The list of drugs a Part D plan covers is listed under the formulary list. The drugs are then divided into tier systems. Before you choose a Part D plan, there are some important things to consider. In this article, we’ll focus on the top three things you need to consider before choosing a Part D plan. 


This is one of the most important factors to consider before you choose a Part D plan. The costs to consider include premiums, deductibles, copayments, and coinsurance. Premiums are monthly payments you are required to pay to have the plan. Since Part D plans are provided by private insurance companies, the premium rates will vary depending on the plan and the insurance company. The key is to choose a plan that is suitable for your prescription drug needs and also falls within your budget. 

Also, your Part D premiums may be affected by your income. Beneficiaries with a higher income may pay more for Part D coverage. Part D deductibles refer to the amount you will pay for prescription drugs before your plan starts to pay. Some plans have a $0 deductible, while some have high deductibles. However, there is a limit on how high the deductible can be. 

Before you choose a Part D plan, ensure you check all costs before you enroll. Some plans may have low premiums and high coinsurance and vice versa. 

Coverage Options 

Different Part D plans cover different prescription drugs. However, some drugs must be covered by a Part D plan. Part D plans must cover anticonvulsants, immunosuppressants, antidepressants, antipsychotics, anticancer medications, and HIV/AIDS drugs. 

Medicare Part D providers are mandated to include drugs in these categories in their Part D plans. Before you choose a Part D plan, ask for the formulary. The formulary contains the covered prescription medications. Also, drugs are classified under tier systems. The lowest tier contains generic medications, while the highest tier contains specialty drugs. Ensure your preferred plan’s tier contains the drugs you need before you choose the plan.

Star Ratings

The performance of each Medicare Part D plan is measured through the Medicare star rating system. The star rating starts from 1-star and goes up to 5-stars. 1-star equals the lowest rating, while 5-stars equals the highest. This is used to measure the plan’s performance and quality. The star rating is based on factors such as how well the plan deals with complaints, the improvements, and the coverage options. 
Part D plans can help you avoid the high cost of prescription drugs and help you get the prescription medications you need. To get more information and help with prescription drug plans, reach out to us today.

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