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Medicare Drug Plans-Key Factors to Help You Choose The Best Plan Before Your Enroll

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Medicare drug plans can be difficult to navigate. There are several key factors you need to consider before choosing a Medicare Drug Plan. It is an important decision and well worth the time needed to research it carefully. It is okay to go window shopping for a period of time.

This is your health. You need to make a conscious choice on the matter. Below, we will discuss some important tips to remember when you are choosing a Medicare drug plan.

Specific Medications and Medicare Drug Plans

If you are already taking specific medications, then certainly you will want to make sure they are covered under the drug plan you choose. Check several plans as you will find the cost will vary from plan to plan. In addition, when choosing a plan that offers coverage in the “gap”,make certain that your medications are covered. This will prevent high out-of-pocket expenses for your medication.

Deductibles and Coverage

Another money saving tip is to look at Medicare drug plans with a low deductible. To emphasize, if you want continuous coverage, make sure that your plan will cover the cost of your medications during the “gap” period.

Generic Prescriptions

You will find when looking at the Medicare drug plans that they have “tiers.” If you plan on taking primarily generic medication, then look for a tier that will charge you zero or at least a very low co-payment. On the other hand, if you currently take very few or even no medication at all, pick a plan with a very low premium.

If your circumstance change, you pick a new plan during the next enrollment period. If available, read the reviews for the various plans and make your choice based on your needs and finances.

More About Tiers

Most plans that offer prescription coverage divide their plans or covered drugs into “tiers.” Tiers will vary in price. For example, the lower tiered plans will cost less. Tier one, for example, while costing less, will cover most generic prescriptions. Your co-payment will be less than a Tier 2 drug.

However, under tier two, you will be able to get brand name medications. There is also a specialty tier for very high cost medications.

The Cost

The cost of Part D premiums on Medicare is based on your income. Medicare will use your tax return to determine your cost, if any for Part D. For instance, if your yearly income is more than $87,000 but less than $109,000 than your premium will be $12.20 in addition to premium of the plan you choose. If you earn more, the premium will be more. If you make less, there is no premium.


A deductible is the amount you will need to pay before your plan begins to pay for your prescriptions. Depending on the plan you choose, your deductible will vary. Some plans will have no deductible at all. However, an important reminder is that the deductible limit for any Medicare drug plan for 2019 is $415.00. Shop carefully when choosing a plan.


Convenience is an important factor to consider when choosing health care and pharmacies. Make sure the pharmacy you prefer to use is in the network of pharmacies that offer the prescription coverage you need.

The hours should be this way as well. Do you work all week? Are the open on a Saturday? What about the pharmacy? Is the pharmacy in your network? Will you need to pay extra for this?


There may come a time when you need to travel outside of this country. It may be for a long period or a short period. Will your plan be okay and accepted where you need to travel? Ideally, you will want to bring any needed prescriptions with you. However, emergencies occur. Will you need to pay extra for the medications you make outside of the country? How much will this cost you in the end?

Choosing the Plan

Your aim in choosing a prescription plan is three-fold. First, you want a plan that covers your current medications. Second, look for the lowest out-of-pocket cost. Lastly, you want a plan that will give you good service when questions arise. Your needs are an important factor. There are several ways you can obtain help to make the best choice.

Getting Help

The Medicare website is a good place to start. There, you will find answers to the many questions you may have. If you are comfortable on a computer, then go to their website and start by entering your zip code. When prompted, fill in the medications you take and you will be started on a path to choosing a plan.

If the computer isn’t your thing, then call the Medicare help line. The number is 800-633-4227. This is a 24/7 line, so feel free to call at your convenience.

Local Help

If you prefer face-to-face contact, then contact your state health insurance program, also known as SHIP. Here you can sit down with a counselor at no cost. You will receive advice on the plans available and will best suit your needs. To find your local office visit www.shiptacenter.org