Choosing a Medicare Drug Plan: Important information from Medicare & You 2008 (CMS publication)

Each Medicare drug plan is different. When you choose a Medicare drug plan for the first time, or switch to a different Medicare drug plan, [more] you should compare the plans in your area. Choose one that meets your needs based on coverage, cost, and convenience. If Medicare automatically enrolled you in a plan, you can change to a plan that better meets your needs. Visit www.medicare.gov on the web, or call 1-800-MEDICARE (1-800-633-4227) to get information about the Medicare drug plans available in your area. TTY users should call 1-877-486-2048.

Things to Consider When You Compare Plans

Coverage: Check to see if the plan covers your prescription drugs.Medicare drug plans have a list of drugs covered by the plan (formulary) that must always meet Medicare’s requirements. Even if a drug is on the plan’s list, there may be special rules for filling the prescription. See pages 63–65 for important drug coverage rules. Your plan’s formulary may change during the year because drug therapies change, new drugs are released, and new medical information becomes available. If there is a formulary change that affects a drug you take, your plan must notify you at least 60 days in advance. You may have to change the drug you use or pay more for it. In some cases, you can continue taking the drug you were on until the end of the year. You can also ask for an exception or appeal.

Cost: Check to see how much your prescription drugs cost in each plan.If you currently have prescription drug coverage, compare your current costs to the costs of the Medicare drug plans you are considering. Your monthly premiums, deductibles, and your share of the cost of each drug (copayments and/or coinsurance) will vary with each plan. You may be able to pick a plan with or without a monthly premium, yearly deductible, or coverage gap.

Convenience: Make sure the plan’s pharmacies include the ones you want to use.Some plans also allow you to get your prescriptions through the mail. If you spend part of the year in another state, see if the plan will cover you there.

Get Personalized Help Comparing Plans

Visit www.medicare.gov on the web. Under “Search Tools,” select “Compare Medicare Prescription Drug Plans.” Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Call your State Health Insurance Assistance Program (SHIP). See pages 98–101 for the telephone number. Have your Medicare card, a list of your drugs and their dosages, and the name of the pharmacy you use available.