The best prescription drug plan pays for the drugs you take at the lowest cost to you, has a history of top customer service and is available in your ZIP code. Medicare's website, Medicare.gov, offers all the information you need to choose a plan, including quality ratings. The ratings range from 1 to 5 stars and cover four categories of drug plan performance:
- Customer service, including appeals handling.
- Member complaints and improvement of plan problems.
- Member satisfaction.
- Drug safety and accuracy of pricing.
Medicare has uniquely complete data and the know-how to analyze it, so its ratings are the best you can get.
Find a Plan
Even if a big health insurer offers Medicare Part D plans from sea to sea, not one of those plans is relevant to you unless it's available in your ZIP code; you can safely ignore articles that offer "best 10" and "best 100" Plan D lists. State laws govern insurance, and not every plan is available even within a given state.
To find the best plan for you, go to Medicare.gov and click the tab labeled "Find Health and Drug Plans." You'll answer a few questions about your Medicare status and then create a list of the drugs you take. You can come back without filling in the drug list again if you take note of the drug list identification number and date (called the password date). Specify two local retail pharmacies, and in short order, you have a list of Part D insurance plans to choose from -- sometimes dozens of them.
Find Your Prescriptions
Look first for plans that cover all your drugs; it's not a sure thing that they will. If you're a typical diabetic living in Houston and you use two particular brand-name drugs, only nine out of the 32 available plans covers every drug. Only four plans cover all of this specific person's needs.
If no plan covers all your prescriptions, use Medicare's estimates to find out which plan covers the most expensive of them so that you pay out of pocket only for the cheapest. The medicine not covered is most likely on the pricey side. Medicare.gov suggests ways to cut your costs, usually by suggesting a generic equivalent for the drug.
Find the Best Buy
Now you can search for the plans that maximize your dollar. A few years ago, this was an imposing chore, but now Medicare.gov does the calculations for you by estimating the coverage cost for each plan, based on your drug list.
You'll have to play around with Medicare.gov's side-by-side plan comparison feature to find out which plan is the least expensive. Costs vary for generic drugs, which are cheaper than new, brand-name drugs even if the generic is a non-preferred brand. For some drugs, the copay might cover the entire cost. Sometimes prescriptions are available by mail, sometimes not. The range of out-of-pocket costs can vary by thousands of dollars, and they could change if you specify a different retail pharmacy.
Choose by Quality
Make sure that your prescribing doctor is signed up for the Part D plans that interest you. As of December 2015, Medicare will cover your drugs only if your physician is enrolled in Medicare or has an opt-out affidavit on file with Medicare.
From this point on, you can use the quality ratings to screen for the best plans. If you end up with several nearly identical plans, simply pick the one with the highest rating. The difference between 3.5 stars and 4 stars shouldn't make you turn away from the plan that costs less. If there is a plan with 2 stars and a plan with 4, though, your choice is clear.