Pottstown’s Medicare Education Services: Ask Dave

Medicare Education Services
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06 Medicare Education Services -

What are the differences between the different Medicare Prescription Drug Plans? Joanne G. Norristown

That’s a common question Joanne. Before we get to what is different, let’s look at what is the same with all Part D Prescription Drug Plans (PDP’s).

All Part D PDP’s are offered through private insurance companies and go through four stages of spending. A Medicare Beneficiary moves through these stages based on shared spending between the Beneficiary and the drug company, so as you move through the different stages, the cost of your drug will change.

The differences in Part D PDP’s have to do with your cost, both in terms of the premium you pay for the plan and the amount you pay for your drugs.

The premium, or money you spend to buy your drug plan, will be different with each plan.There are Part D plans that are included in Medicare Advantage plans. Medicare Advantage (MAPD) plans cover all of your Medicare Parts A and B benefits, as well as Part D coverge . There are also stand alone Part D plans. These plans have a premium that can range from around $10/month up to over $100/month.

Another difference between PDPs is the actual cost of drugs from one plan to the next. Drug companies place covered drugs on a formulary, or list of drugs. Each drug on the list is given a tier, from tier one to tier five, with tier one being the least expensive, and tier five being the most expensive.

Each drug company has a different formulary.

That means a tier 3 drug with one company may be a tier 2 drug with another company. Based on your personal drug regimen, different PDP’s will be more cost effective for different people. That is why it is wise to review your PDP plan during the Annual Enrollment Period. This ensures you are in the best plan for the drugs you take. People can often reduce their drug cost by selecting a different PDP.

Questions about your drug plans? Call Dave, a licensed agent, at 484.424.5222 for assistance.