One of the biggest concerns when it comes to Medicare is, “What is the best way to get my prescriptions covered?” It is easily one of the most confusing parts of Medicare. The most important thing to remember, the best plan for you revolves around your prescriptions.
When it comes to drug plans, they all have different formularies, covered drug lists, and the tiers, drug class, they fall into. It is not uncommon for one plan to cover a specific prescription as a tier 2 generic and another to cover it as a tier 3 preferred brand, or simply not cover it at all.
Medicare does require all drug plans to carry at least one type of every prescription on the formulary, you can always see if your doctor can try a different prescription that does the same thing if it is not on the formulary of your plan.
You can only change your prescription coverage during the Annual Enrollment Period, October 15th – December 7th, or during the General Enrollment Period, January 1st – March 31st. There are special exceptions if certain events in your life occur such as moving out of the coverage area of your plan.
Choosing the Best Prescription Drug Plan
Technically the plans are not out for 2019, new plan info is usually released on the 1st of October. However, we can look at history to get a good idea of who will be in the top 5. Plans are rated by star ratings, below you can see what factors contribute to the rating.
Star ratings are determined by:
- Plan customer service – This is related to how well the drug plan serves the member’s needs.
- Member experience with the plan’s prescription drug services – This is how the members of the plan rate it.
- The accuracy of drug pricing and drug safety – This includes how precise the plans cost’s for drugs and premiums are, and how members that have acute medical conditions are given prescriptions in a safe and recommended way for their situation.
- Changes in the plan’s performance and member complaints – This is how often Medicare found issues with the plan, and how often members of the plan filed a complaint. This also includes the amount of improvement the plan has made, if any.
Top 5 Medicare Prescription Drug Plans for 2019
- Silver Script Choice
- Humana Walmart Plan
- Aetna Medicare Select Plan
- Express Scripts Medicare Saver
- UnitedHealthcare MedicareRx Walgreens 1
The highest rating a plan can have is 5-star. Just because a plan is 5-star does not mean it is the top-rated plan in the country, as a matter of fact there is no nationwide plan that has a 5-star rating.
- For several years now, SilverScript has been the number one plan. There are several reasons for this.
- They have a 4-star rating nationwide.
- They have one of the largest formularies.
- The Silver Script choice plan has one of the lowest premiums of all plans without a deductible.
- They have some of the best customer service reviews.
Humana Walmart Plan
- At $22.50 the Wal-Mart plan has one of the lowest premiums of any plan available.
- The Humana Walmart plan has some of the best co-pays if you are willing to get your prescriptions from Wal-Mart.
- They have one of the best mail order options for generic drugs.
- While they do have a deductible of $405 in 2018 this only applies to tiers 3, 4 and 5 drugs.
Aetna Medicare Select Plan
- Like the Humana Wal-Mart plan, the Aetna Select has great co-pays for their generics, tier 1 prescriptions have a $0 copay and tier 2 prescriptions have a $3 copay at preferred pharmacies.
- This plan does have a deductible of $405 in 2018. And like the Humana Wal-Mart plan it only applies to tier 3, 4 and 5 Prescriptions.
- The Aetna Select plan has the lowest premium of all Part D Plans in 2018.
- This plan is one of the only plans that give you some protection during the coverage gap, you will continue to have copays for tiers 1 and 2.
Express Scripts Medicare Saver
- Like Silver Scripts, the Express Scripts Medicare Saver plan has a 4-star rating.
- It has a monthly premium under $30.
- Similar to Silver Scripts, the Express Scripts Medicare Saver plan has a very large formulary.
- The copay for a tier 1 and 2 prescriptions is affordable. However, once you if you have prescriptions for drugs from the other tiers you will be paying a percentage of the actual cost of the drug instead of a fixed copay.
UnitedHealthcare MedicareRx Walgreens 1
- Rounding out the most popular plans, the United Healthcare.
- The MedicareRX Walgreens 1 plan is a 4-star rated plan.
- It has a $0 copay for Tier 1 Drugs.
- It does have a $405 deductible
- It also has a monthly premium under $30
There are many choices when it comes to your Part D Prescription Drug plan, you should always consult with a licensed agent to ensure your drugs are covered on the plan you choose before enrolling.
If you would like to compare rates in your area, the Part D plan finder tool will do just that.