Find a Preferred Pharmacy
When you enroll in a Medicare Part D plan, the plan will offer a network of pharmacies where you can fill your prescriptions. Plans partner with many different types of pharmacies — independent community pharmacies, chain drug stores, grocery stores and major retailers — to offer enrollees choice and convenience when filling a prescription. The size of the pharmacy network varies by plan. Some plans have a network of 60,000 or more participating pharmacies nationwide, while others offer smaller networks of 30,000 or less.
There may be 2 two types of pharmacies in a Part D pharmacy network:
Preferred pharmacy:
This term refers to a smaller number of pharmacies within a plan’s network that have agreed to charge a lower cost for your medication. When you use a preferred pharmacy, your cost-share, which is your copayment or coinsurance, will lower your medication costs.
Standard pharmacy:
This term refers to the pharmacies that participate in your plan’s network that will charge a higher copayment or coinsurance than if you use a preferred pharmacy.
After meeting any deductible, your plan will cover the cost of your prescription, minus your copayment or coinsurance, at any standard pharmacy in the network. Your copayment is your “standard cost-share.” You can save even more money, however, by using a preferred pharmacy. The lower copayment or coinsurance you pay at these pharmacies is your “preferred cost-share.” Many times, the cost savings available from using a preferred pharmacy can exceed the cost of paying a slightly higher monthly premium. Using a preferred pharmacy also can help you delay reaching the Coverage Gap (donut hole) by keeping your overall prescription drug costs down.
Learn about hurdles to jump before your drugs will be covered
Make sure that all of your drugs (or their generics) are covered under your drug plan. If not, you may find yourself having a difficult time paying for those prescriptions. Further, learn the ins and outs of your plans coverages and coverage gaps (donut holes).
Find Out If Switching to Generics Can Save You Money
In most cases, generic drugs can save a great deal of money. Almost 80% of FDA-approved drugs have generic alternatives that cost an average of four times less than the brand-name versions.
If you take a medication that is going off patent, however, you may need to wait six months to enjoy huge savings. Drug makers can limit generic competition for six months after a drug’s patent protection expires. In time, cheaper generic options become available.
Whatever the drug, make sure to speak openly with your doctor and pharmacists, and ask the questions that you need answered.
Check if the Plan Matches Your Budget
When choosing a plan, make sure that the plan fits comfortably into your budget, and takes into account any coverage gaps that you may experience down the road. It’s best to consult with an experienced insurance agent that can answer your questions, and ensure that all of your drugs are covered. To request a free quote from our experienced health insurance agents, use the form on this page or click here.
