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If you recently turned 65 or will be soon, Medicare plans and costs may be on your mind.
While prescription drug coverage is not required by Medicare, most people are advised to have some form of "creditable" drug coverage if only to avoid paying penalties if they sign up for Medicare drug coverage later. Most people who enroll in Medicare get drug coverage through either a Medicare Advantage Plan or Medicare Part D. Both of these options come from private providers. The plans are approved, but not funded, by the federal government.
As a member of one of these plans, you pay a premium to the provider. In turn, your prescription drug costs are covered. In 2020, 46.5 million of the more than 60 million people covered by Medicare were enrolled in Part D plans, making it the preferred choice for prescription coverage.
All Part D plans meet specific Medicare rules about what type of drugs must be covered. Each drug plan will have a formulary, which is a list of medications covered, in three tiers. The lower the tier, the lower the cost for the drug. The drugs in the highest tier, often known by their brand names, cost the most.
Before you sign up, you need to look around for your Medicare Part D plan and compare costs. You don't want to end up paying more than you have to for the drugs you need.
Best Overall : Humana
Three plans to meet your needs.
CMS Star Rating of 4.
Lowest premiums in 47 states plus Washington, D.C.
Three mobile apps.
Humana Value Rx Plan PDP may not serve all areas.
The site is slightly hard to move around on.
Humana is one of the most well-known health insurance providers. It has nearly 17 million members in the U.S. Humana earned a four-star rating from the Centers for Medicare & Medicaid Services (CMS) and has a strong financial backing.
The Humana Walmart Value Rx Plan has an affordable premium of just $17.20 per month, with no deductible on tier 1 and tier 2 medications. Tier 1 drugs typically include common generics such as ibuprofen 400 mg. Tier 2 drugs include generics that are not part of Humana's preferred network. Metformin, for instance, is a tier 1 drug for diabetes, while Invokana is tier 2 or tier 3, depending on the plan.
The Humana Premier Rx Plan also has no deductible, but premiums range from $58.30 to $72.50, depending on the state. Either plan can be a good value for people with only a few prescriptions each month to fill.
The Basic Rx Plan has extremely low copays after the $445 annual deductible, making it better for people with costly prescriptions.
The company offers a wide range of useful member services and apps, including the Go365 fitness app, the MyHumana app that puts your health information right at your fingertips, and the Humana Pharmacy app, which allows you to manage your drugs from your mobile device.
The Balance chose Humana for its reputation, the depth of its member programs, and the two low-cost plans that also include no deductibles on tier 1 and tier 2 drugs.
Best Overall, Runner-up : Cigna
Easy to compare plans online.
Drug plans can be found in all 50 states.
Wide-reaching website with resources for Medicare members.
Three mobile apps allow you to manage your policy, search for medications, and manage your health from anywhere.
4.5-star CMS Rating
Rx Secure has high premiums and a high deductible.
Cigna may not have the lowest premiums of the plans we looked at, but the website makes it easy to find what you need. Cigna is financially stable and has three choices for Part D. These reasons put Cigna near the top of our list for best Medicare Part D health insurance providers. Cigna has an AM Best rating of A, which means it is stable.
Cigna offers three choices in Medicare Part D plans:
- Cigna-HealthSpring Rx Secure
- Cigna-HealthSpring Rx Secure-Essential
- Cigna-HealthSpring Rx Secure-Extra
The Rx Secure plan has a $445 deductible. If you order through the company's mail-order pharmacy, you can save with copays as low as $0 on tier 1 drugs like metformin and naproxen.
The Secure-Essential plan offers no deductible on tier 1 and tier 2 drugs, with no copay for tier 1 drugs ordered through select mail-order pharmacies. With monthly premiums listed at just $24, this may be one of the cheapest plans available. The Secure-Extra plan has the lowest deductible of the three options ($100), with a higher monthly premium of $50.
No matter which plan you choose, the myCigna mobile app makes it easy to manage your drugs from your mobile device and order them for home delivery.
The company's financial stability is shown by its No. 13 ranking on the Fortune 500 list.
You can buy your plan online or call to speak with a representative for help. The website offers many resources, which include videos and articles, for anyone with questions about Medicare or which plan they should buy.
Best Online User Experience : AARP/UnitedHealthcare
Website is easy to get around and is packed with info.
Easy to compare plans online.
Low-cost premiums and two plans with $0 deductibles.
Two mobile apps make it easy to manage your insurance and your health.
Preferred pricing only at Walgreens and Duane Reade.
High premium on the Preferred Plan.
We chose UnitedHealthcare (UHC) because it's easy to choose from the three plan options on its website. UHC outlines premiums, deductibles, and copays on drugs in different tiers in a chart that is easy to read.
UHC's Part D plan is one of the more costly on our list, but it's worth it for the value and level of customer service it provides. With a five-star CMS rating for customer service and many awards, UHC offers premier service that starts with a website that's easy to get around.
Three UHC plans are offered through AARP and include:
- AARP Medicare Rx Walgreens
- AARP Medicare Rx Preferred
- AARP Medicare Rx Saver Plus
The Walgreens plan has a $0 deductible on tier 1 drugs and no copay if you fill your prescriptions at Walgreens. It comes with a monthly payment of $35.40.
The Preferred Plan has no deductible and comes with an $88.70 monthly payment. It offers good pricing on tier 3, 4, and 5 drugs, starting as low as one-third of the list price. Some other plans split the costs for top-tier drugs evenly with the customer.
The Saver Plus plan has a $445 deductible with a monthly premium of $54.20, with only a $1 copay on tier 1 drugs such as meloxicam and amoxicillin.
UHC offers the Health4Me app to track your drugs, store digital copies of your card, and more. The OptumRx app is for those who order medications through the provider's preferred online pharmacy.
The company makes it easy to find an agent in your area to work with in-person, enroll directly online, or call to speak to a representative between 8 a.m. and 8 p.m., seven days a week. It also offers a free online Medicare guide to help you explore your options.
Best for Low Premiums : Wellcare
Six different plans available.
Low-priced plans with no deductible.
Wealth of resources on the website.
Affordable plans starting at $15.70 per month.
Only available in 27 states.
The mobile app, StayWell, isn’t very robust.
Can be hard to find your way around the website.
The preferred pharmacy is CVS, which may not be available in all areas.
WellCare Health Plans, Inc. serves 6.4 million members. It has been included in our best Medicare Part D Plans because of its choice of six different prescription drug plans, many of which are very affordable.
The Wellcare Wellness Rx plan has copays starting at $0 and a monthly payment of just $15.70. Best of all, there's a $0 deductible on tier 1 and tier 2 drugs on this plan, including some forms of penicillin. You'd be hard-pressed to find more affordable drug coverage with no deductible on tier 1 and 2 drugs.
The deductible for tiers 3, 4, and 5 is $445. Examples of tier 3 drugs include doxycycline, while tetracycline is a tier 4 drug.
Likewise, Wellcare Value Script has no deductible on tier 1 and tier 2 drugs. The difference in these plans is the formulary, so be sure to review the plans carefully to see if it covers your choice of drugs.
The WellCare Medicare Rx Value Plus is the priciest of the plans, with a monthly premium of $74.60, but there is no deductible for drugs on any tier.
If you don't have a CVS Caremark pharmacy near you, you'll pay a copay of $5 or more, depending on the drug's tier.
Wellcare's website does not offer all the bells and whistles of some of the other plans. It doesn't offer much information, and it's not easy to find what you need. The company only has one mobile app that allows basic functions like storing a digital copy of your Medicare card. It could be a good plan for those who use tier 1 and tier 2 drugs or who only need drug coverage to avoid penalties.
If you choose one of these low-cost plans and later require drugs that have a deductible, you can change plans without penalty during the Medicare enrollment period.
Best for No Deductible : Aetna
No deductible on either plan.
Online enrollment available.
SilverScript Choice is available in all 50 states.
High CMS ratings.
SilverScript Plus not available in Alaska.
Higher premiums than some competitors.
Aetna offers three Medicare D plans: SilverScript, SilverScript Choice, and SilverScript Plus. The SilverScript Choice plan has no deductible for drug tiers 1 and 2. A monthly premium of $28.49 makes the SilverScript Choice plan one of the cheapest available in all 50 states. There are no copays on tier 1 drugs and $5 copays on tier 2 drugs.
The SilverScript Plus plan has no deductible at all and copays of just $2 on tier 2 drugs. You'll pay $69.52 per month for the plan, so it makes sense to do the math on your drug costs.
Aetna works with a network of 65,000 pharmacies, with CVS and CVS Caremark being the preferred providers. Finding a pharmacy and looking up your drug costs online is easy. By signing up for a CVS Caremark account, you can set up automatic premium payments, check the formulary, get drug pricing, and find options to save money on your drugs.
Aetna has high CMS ratings of at least 3.5 stars for all its Part D plans. Ratings vary with state and county. Many of them receive 4 or more stars.
How to Shop and Compare the Best Medicare Part D Plans
Follow these steps to help the process go smoothly:
Medicare has special rules about when you can enroll in a drug plan. Your initial Medicare enrollment period begins three months before you turn 65 and ends three months after your 65th birthday. You can also enroll during the first three months of the year or during the open enrollment period, from October 15–December 7.
You could pay a lifetime penalty if you opt out of prescription drug coverage during your initial enrollment period and decide to add Part D or Medicare Advantage more than 63 days after your enrollment period ends. The penalty rises the longer you go without coverage, so it pays to plan ahead.
Step 2: See Which Part D Plans You Can Get in Your Area
Shop online for a Medicare policy, including Part D, at Medicare.gov. When you visit the site, you don't need to log in, but you will have to enter your ZIP code for the right pricing.
Step 3: Make a List of All the Drugs You Take
It's crucial to research which providers cover your drugs and how much they cost if you don't meet your deductible, which will vary based on your plan.
The drugs covered by a Part D plan are listed in the provider's formulary, which is a list of drugs, including generics and brand names, covered by your insurance. For instance, common antibiotics or high blood pressure drugs are often available as generic options.
As long as you already have a Medicare Part C or Part D plan in place, you can always shop around during the open or general enrollment periods for one that better meets your needs and budget.
Step 4: Compare Prices for Your Drugs
Checking the cost of your drugs isn't the only thing you should do. You should also see where your prescriptions are on the plan formulary. You'll also want to look at the monthly payment you will make for your plan. You should be able to manage your monthly payment while also being able to pay for your medicines.
Step 5: Get More Opinions
State Health Insurance Assistance Programs offer free advice for people getting Medicare for the first time or changing their plans.
Insurance brokers can also walk and talk you through which plan is best for you. It does not cost you any more to purchase Medicare through a broker. It could save you money because brokers have relationships with carriers and may be able to get you a better option.
Websites like medicarerights.org also provide unbiased guidance.
Step 6: Sign Up
Your health insurance broker or your carrier of choice can help you sign up for your plan. You can also get help from someone at Medicare.gov once you've made your selection on the website.
Is Part D Cheaper Than Medicare Advantage for Drug Costs?
Medicare Advantage, sometimes called Medicare Part C, bundles all your Medicare benefits under a single plan from a private insurance company. Medicare D, on the other hand, only offers drug coverage.
Depending on the tiers of prescription medications, copays might range from $0 for generic drugs up to $25 on Part D.
We ran the numbers on a few of the Medicare Advantage plans available in New York and found that drug coverage varied widely. The EmblemHealth VIP Value HMO quoted an affordable price (before the $295 deductible) for three common drugs used for type 2 diabetes, high blood pressure, and high cholesterol.
Will Medicare Part D Cover COVID-19 or Flu Vaccines?
Medicare Part D does not cover flu vaccines. Medicare Part B may cover one flu shot per season through an approved health care provider.
Medicare Part D will cover a COVID-19 vaccine, according to the Coronavirus relief act.
Does a Medicare Advantage Plan Cover Drugs?
Not every Medicare Advantage plan covers drugs, but most allow you to add prescription coverage as an option. Medicare Advantage covers everything Medicare Parts A and B cover. Medicare Part D only covers prescription drugs.
What Does a Medicare Advantage Plan With Drug Coverage Cost vs. Medicare Part D?
Since Medicare Advantage and Part D are both written by private insurers, premium and drug costs vary widely. In 2020, the average base premium for Medicare Part D was $32.74 per month.
On the other hand, Medicare Advantage plans may start as low as $0 per month. The average plan costs around $23.63 per month, with drug coverage available at an additional cost.
What If I Want to Change My Medicare Advantage Plan to Medicare Part D?
You can switch from a Medicare Advantage plan to Medicare part D during Medicare's general enrollment period during the first three months each year. If you miss that period, you can sign up during the open enrollment period, from October 15 through December 7.
You may be able to change your plan at other times for some special reasons. These reasons include, but aren't limited to:
- Moving to a new address.
- No longer qualifying for Medicaid.
- Losing Medicare coverage through your provider for any reason.
How We Chose the Best Medicare Part D Companies
We looked at many plans from most of the major Medicare Part D providers, entering the same location into Medicare.gov to view our choices. Based on the offers, we then went to the website for each of the best options. We looked at more than 30 plans from eight providers. We evaluated the user experience on each site, the availability of a mobile app, pricing, coverage, financial stability, Medicare Star Ratings, and availability across the U.S. We looked for companies with high ratings, few customer complaints, widespread availability, and good pricing across drug tiers 1 through 5.