Medicare Part D for 2021

How To Select The Best Medicare Part D Plan For 2021

If you are covered by a Medicare Part D drug plan this year or will turn 65 soon and will be covered for next year, it is important to be sure you have the best plan for YOU and your situation. Before you start the process of finding the best plan, gather your Medicare card and all your prescriptions. You will need to know drug names, number of pills and dosages All of that is on the bottles.

UNDER NO CIRCUMSTANCE assume that the plan you took last year, is the best plan going forward for next year. Do not assume what is best for your spouse or friend will be best for you. There are at least eight reasons why you have to verify the best plan for yourself, every single year, during the open enrollment from Mid-October through early December.

1. You may take different drugs than last year
2. Plans may have changed premiums
3. Plans may have changed how they categorize drugs, thus impacting the cost to you
4. The drug manufactures could have changed prices, which will impact the best plan for you
5. New plans may have been introduced that were not available in the past
6. New generics may have come out and can replace name-brand drugs that you were taking
7. Some plans get terminated and you are automatically enrolled in an alternative plan that may not be in your favor
8. Pharmacies change their participation pricing levels with different plans 

There are Four Primary Ways to Verify the Best Medicare Part D Plan for You:

1. Log on to the Medicare website and use their system. You can see all the plans in one place and what each would cost you next year. You can then sort by which plan is best for you based on which pharmacy you like to use. You may have lower costs if you use a different pharmacy or use mail-order services. For complete instructions on how to use the website go here. (link to the revised article from last year)
2. Call the Medicare toll-free number 1-800-633-4227 to get personalized help. It is available 24 hours a day 7 days a week but be prepared to be on hold (I was on for 16 minutes on a test call). They are very busy. Be ready with all your drug information and what pharmacies you would consider using as well as have your Medicare card.
3. Contact the local HICAP office (Health Insurance Counseling & Advocacy Program) and make arrangements to have a volunteer help you with the process of determining which plan is best. To find the local office near you look at their website at https://cahealthadvocates.org/hicap/
4. Contact a broker/agent that gets paid a commission when they sign you up for a plan. Some agents/brokers will help you determine the best plan and if they do not sell that particular plan they will still recommend that you contact that company to get signed up. If one of their companies is best, then they can sign you up and get paid a fee. Unfortunately, there are some brokers that will recommend the best plan that they can sell you rather than what is best for you. That is why this methodology should be your last choice.

My Personal Experience with the Medicare Website.

Last year, I used the Medicare site and took the plan with the overall lowest costs. It worked well during 2020. I take one high blood pressure RX twice daily, a Cholesterol RX every day and one RX is for when I get a cold sore. I also stopped 2 other meds during the year, changed the dose on another and the doctor prescribed a new medication, so the drugs are different this year to the last. I went to the Medicare site, which is a little different than last year but is very similar. 

Of the 32 plans that are offered for next year, it turns out that a different plan will be the lowest cost for me for next year.  Here is what I found for me and the medications I take. Yours will be different.

                                                      Lowest cost plan          My plan from last year        Highest cost plan

Plan premium only            $7.20 a month                $13.30 a month                        $130.40 a month

Premium & drug costs     $130.40 year                  $264.25 a year                         $1681.00 a year

Findings. By having checked the best plan, rather than keeping what I had, I will save $134.15 for the year in overall costs. By avoiding the most costly plan, there is a potential savings of $1,537.60.

                                                     Before deductible    After deductible    In the gap        After gap

Costco or mail order       $44.00                              $44.00                          $12.08              $8.02

Safeway                                   $44.20                            $44.20                           $12.08              $8.02

CVS                                            $44.40                            $44.40                           $12.38              $8.56

Rite Aid                                    $158.45                        $158.45                        $56.33              $13.42

Horsnyders*                                    Does not participate

West Side Pharmacy*                Does not participate

                                                               *(Locally owned family Pharmacy) 

If you Should Try Option One, Logging into Medicare, here are some helpful hints:

1. Go to - Find a 2021 Medicare Plan

2. Click the button in the middle of the screen

3. On the next page: If you have not logged in before, click the button at the bottom of the screen

4. On the new screen “Create account”, answer all the questions that are asked.  You cannot use the same email for two people. You each should have your own.  The date that your Medicare started is on your Medicare card as is your Medicare number.  When you create a username, many people use their email address. Then click next.  If you have logged on in prior years, then enter your username and password. If you do not recall them, there is a process to retrieve them and select a new password - follow the instruction

 5. After creating the account, log into the site and enter your username and password. The next screen you see will be “Answer a few questions.  Since you will be looking for a “MEDICARE PART D PLAN”, click the button to the left of that option. (Second from the top of the 4 options.)  Enter your Zip code, verify the city is correct and click the “Next” button in green.

6. On the next page, confirm the drugs that you take. The list starts with what you entered last year and often there have been changes. BE SURE THE LIST IS COMPLETE AS TO Name, dosage, the number of pills, frequency. Having the wrong information could lead to the wrong plan so be as accurate as you can. When the list is complete and accurate, click the green button at the bottom “Done adding drugs”

7. The next screen you see will be “Pharmacy selection”. Since prices can vary with a plan from one pharmacy to another it is suggested that you enter your favorite (mine is Costco) and then enter  4 others such as Safeway, CVS, Rite Aid and the mail-order option. Many are listed. If you do not see the ones that you usually use, click the button near the bottom that will show the next batch. Click the box to the right of the name of each Pharmacy that you use. (no more than 5). Then click the white button “Done” in the blue band at the bottom of the page.

8. The next page you see will start with the number of plans available. The first plan listed will be the current plan you are on this year. You will see several dollar amounts numbers associated with the plan.

1. The first is the cost of only the premium for the plan each month.
2. The second is the projected premium for the plan PLUS the cost of the drugs for the year either in the brick and mortar store as well as for the mail order option THESE TWO ARE THE IMPORTANT NUMBERS.
3. The third amount is the plan deductible for the following year that applies to nongeneric drugs.

9. Below the box with your current plan, on the right, you will see

Place your curser on the downward arrow and three option will appear. Select the one that reads

10. What you will then see, below your current plan, is the list of all the plans that are available based on the least overall costly plan leading to the most-costly. In most cases, it makes sense to use the plan that has the lowest overall cost. Do not be influenced by which plan has the lowest premium.

Click on the plan details button on the left of each plan you wish to review. If you want to see the difference between your current plan and the lowest cost option (or any other plan) click on the blue button on the right.

Then scroll to the bottom of the page and click the white button in the blue band that says “Compare”. There is a very nice comparison where you will note the differences, including the costs based on the Pharmacy that you use to get the drugs.

11. Once you have made a decision click on the “Enroll” button and complete the information. Remember that the best plan for you is based on where you live, the drugs you take and the Pharmacy that you use. This means the best plan for your friends, spouse or other family members could be different than what is best for you.

If you have any additional questions, please feel free to reach out. 

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