I need a prescription drug plan.

What do I need to know before choosing a plan?

Choosing a Medicare Prescription Drug Plan is an important decision. By determining your needs, you can assess the plans and decide which one is best for you.

1. Find out if you already have prescription drug coverage that is at least as good as the Medicare Prescription Drug Plan (Part D).

  • If you are retiring, talk to your employer about your prescription drug coverage.
  • If you have group insurance, you will receive a letter from your employer explaining how your prescription drug benefits compare to the benefits offered through Medicare Part D.
  • If you have individual insurance, talk to your carrier. You will receive a letter from your carrier explaining how your prescription drug benefits compare to the benefits offered through Medicare Part D.

2. Determine your costs, being sure to include:

  • Premiums
  • Deductibles
  • Copays/Coinsurance
  • Whether or not you will have coverage for generic or brand-name drugs during the coverage gap

3. Find out if your exact drugs are covered.

  • Gather the bottles of every prescription you take.
  • The bottles indicate the names of the drugs, the dosages, and the frequency with which you must take the drugs.
  • Your pharmacy may also be able to provide this information to you, especially if you fill all of your prescriptions at one pharmacy.
  • Search the Medi-CareFirst Formulary to see if your drugs are covered.
  • Estimate your costs by checking the copay amounts for the prescription drugs you take.

Your doctor may be able to prescribe an alternate drug, if a drug that you take is not in the formulary. If you are taking a brand-name drug, your doctor may also be able to prescribe a generic.

Find out if there are restrictions on the drugs you take. For example, is prior authorization required? Most plans' formularies provide this information.

4. Finally, determine whether your pharmacies participate in the network.

  • Make a list of the names and addresses of the pharmacies where you purchase prescriptions and search for them using the Medi-CareFirst Pharmacy Locator.
Additional Information
  • Enrolling in a Part D plan does not replace your need for Medicare or your current Medigap plan.
  • Blue Rx plans cover most drugs that Medicare has approved for Part D.
  • Sign up when you become eligible or you may have to pay a penalty.
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