Get the Best Medicare Prescription-Drug Plan for You

Now that it’s open-enrollment season for Medicare prescription-drug plans, how can I figure out which is the best plan for me this year?

Open-enrollment season for Medicare Part D plans runs from November 15 to December 31, and this is your opportunity to sign up for the plan that will cover you for 2010. The Medicare.gov Web site has a great tool that can help you pick the best plan for your particular situation. All Medicare beneficiaries should use this tool to compare their options -- even if you are happy with your current plan.

Many plans are raising rates, boosting out-of-pocket costs and changing the coverage level for some drugs. And several of the most popular plans have had some of the biggest price increases over the past few years (see Choose the Right Medicare Plan for Your Needs for more information). The plan you chose a few years ago may no longer be your best option. The key is to compare premiums as well as out-of-pocket costs for your particular medicines.

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Fortunately, there’s a relatively easy way to do this, if you know how to navigate through a special tool on the Medicare.gov Web site. Start by going to the Medicare Prescription Drug Plan Finder tool and clicking on “Find and Compare Plans.” You can either do a personalized search, based on your current enrollment information, or a general search. If you prefer to do a general search, you’ll type in your zip code, age range and health status, then answer questions about whether you currently have prescription-drug coverage or other health coverage and whether you qualify for low-income subsidies to help with Part D costs.

You’ll be shown a screen that includes general information about open enrollment. Then you’ll click to the next screen, which lets you enter your specific drugs and dosages. If you choose brand-name drugs, you can click on a box labeled “use lower cost generic drugs when available.” Generics can lower your costs significantly (ask your doctor whether you can switch to any generics before you make a final decision about your coverage, because the best plan for generics may be different than the best plan for brand-name drugs). You can either save your drug list for future searches or add more drugs. You’ll then fill in more information about your medicines’ refill quantity and frequency. You can set up a password to access the information later, or you can skip that step. You can then choose specific pharmacies in your area, or keep the results more general.

After that you’ll see a big table with all the information you need to compare plans. The top line is for Original Medicare, which shows what the out-of-pocket costs for your medications would be if you didn’t have a Part D plan. Below that are the details about the plans in your area. You can sort this list in a variety of ways, but the best way is to list the plans by estimated annual cost using retail pharmacies or mail-order pharmacies, whichever you plan to use (you can generally save money by using mail-order pharmacies).

By clicking on the boxes next to specific plans you can select up to three to compare -- just click on the “compare” box after you select them and you’ll be directed to a page that shows detailed information about the plans side-by-side. This chart makes it easy to see why it’s important to focus on total annual costs rather than premiums. A plan with low premiums might have a higher deductible and higher co-payments for your drugs, and it could cost a lot more by the end of the year than a plan with higher premiums but no deductible and smaller co-pays for your drugs.

You’ll also see contact information for each of the three plans, as well as star ratings for various quality measures -- including customer service, plan member complaints, members who chose to leave, Medicare audit findings, member experience with the drug plan, drug pricing and patient safety. Click the link at the top to view more details on plan ratings, then click on “show more information” for each category to see ratings for several subcategories within each section. You’ll find an incredible amount of detail about people’s experiences with each plan.

After you have all of the cost and quality information, it should be easy to pick a plan. But if you don’t feel comfortable doing all that on the Internet, you can get personalized help from your local State Health Insurance Assistance Program. Find contact information at 800-633-4227 or at www.shiptalk.org.

These local programs tend to get busy toward the end of open enrollment, as people scramble to pick a Medicare Part D plan before the December 31 deadline. “If you want to make use of the community resources or senior organizations, don’t wait until the last minute,” says Donna Burtanger, senior director of Medicare for SilverLink, a health-care information company.

Got a Question? E-mail Kim at askkim@kiplinger.com.