How to Compare Prescription Plans using Medicare Part D Plan Finder – Case Study

How to Compare Prescription Plans using Medicare Part D Plan Finder - Case Study

In our post How to Get Low Cost Medicare Part D Plans, we provided several guidelines on Prescription Drug Plans (PDP)  savings. The most important of these are: (a) choice of Part D plan should be based on your list of prescriptions, and (b) always use Estimated Annual Drug Costs rather than Monthly Premium as the selection criteria. Here we’ll illustrate these guidelines using a real drug list (we’ve just changed zip code). The mechanics of “How to Compare Prescription Plans using Medicare Part D Plan Finder” will be made very transparent.

Medicare Part D Plan Finder – Article Contents

Choosing PDP using Part D Plan Finder  – Analysis
What have we learned?
US Government Sources


Choosing Drug Prescription Plan using Medicare Part D Plan Finder - Analysis

Choosing Drug Prescription Plan using Medicare Part D Plan Finder – Analysis

Analysis

Drug List
Prescription Drug Plans
Premiums

Drug List

The drug list used for the case study is shown in Table 1. It has several preferred brand names and at least one non-preferred brand name. For drug lists like this, the difference between Total Annual Costs among different plans is very significant.

Medicine Name Quantity Frequency
Clobex LOT 0.05% 1x118ML Bottle Every 1 Month
Crestor TAB 10MG 30 Every 1 Month
Diovan TAB 160MG 30 Every 1 Month
Meioxicam TAB 15MG 30 Every 1 Month
Metoprolol Succinate Er TAB 50MG ER 30 Every 1 Month

Table 1. Drug List

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List of Plans

We used the Medicare Plan Finder to get a list of available Medicare Prescription Drug plans (zip code 19096). There are 35 plans in 19096 match our drug list. Their Total Annual Costs are in the range from $3,342 (the least expensive) to $16,914 (the most expensive). The selected plans from the list of plans are sorted by the Lowest Total Annual Costs are shown in Table 2.

# Prescription Drug Plan Monthly Drug Premium Annual Drug Deductible Total Annual Costs (Retail) Total Annual Costs (Mail Order) Plan Rating
1 AARP MedicareRx Enhanced (PDP) $87.30 $0.00 $3,342 $3,241 3 out of 5 stars
4 Blue Rx Complete (PDP) $113.20 $0.00 $4,331 $4,258 4 out of 5 stars
6 Humana Walmart-Preferred Rx Plan (PDP) $18.50 $325.00 $11,715 $11,629 3.5 out of 5 stars
23 First Health Part D Premier (PDP) $37.70 $325.00 $12,773 $12,702 3 out of 5 stars

Table 2. Prescription Drug Plans and their position in the List of Plans

Table 2 shows that the difference in Total Annual Costs between the least expensive plan (AARP) and #4 (Blue Rx) is about $1,000. However, the difference between #4 and #6 (Humana Walmart) is more than $7,000.

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How much will you pay?

Tables 3.1 through 3.4 provide more insight by showing how much you pay for each plan. Costs are separated by medicine name, and by Part D stages (initial coverage, coverage gap, and catastrophic coverage).

Medicine Name Tier Initial Coverage Coverage Gap Catastrophic Coverage
Clobex LOT 0.05% Tier 4: Non-Preferred Brand $76.00 $38.00 $34.08
Crestor TAB 10MG Tier 3: Preferred Brand $40.00 $77.15 $8.12
Diovan TAB 160MG Tier 3: Preferred Brand $40.00 $57.62 $6.60
Meioxicam TAB 15MG Tier 1: Preferred Generic $2.00 $2.00 $2.65
Metoprolol Succinate Er TAB 50MG ER Tier 3: Preferred Brand $24.44 $19.31 $6.60

Table 3.1 What you pay – AARP Medicare Rx Enhanced

Medicine Name Tier Initial Coverage Coverage Gap Catastrophic Coverage
Clobex LOT 0.05% Tier 3: Non-Preferred Brand $70.00 $335.99 $35.37
Crestor TAB 10MG Tier 3: Non-Preferred Brand $70.00 $80.02 $8.42
Diovan TAB 160MG Tier 3: Non-Preferred Brand $70.00 $59.76 $6.60
Meioxicam TAB 15MG Tier 1: Generic $7.00 $4.90 $2.65
Metoprolol Succinate Er TAB 50MG ER Tier 1: Generic $7.00 $11.82 $2.65

Table 3.2 What you pay – Blue Rx Complete

Medicine Name Tier Initial Coverage Coverage Gap Catastrophic Coverage
Clobex LOT 0.05% Not on Formulary $822.36 $822.36 $822.36
Crestor TAB 10MG Tier 3: Preferred Brand $42.28 $80.72 $8.50
Diovan TAB 160MG Tier 3: Preferred Brand $31.77 $60.36 $6.60
Meioxicam TAB 15MG Tier 1: Preferred Generic $5.00 $3.95 $2.65
Metoprolol Succinate Er TAB 50MG ER Tier 2: Non-Preferred Generic $17.46 $13.79 $6.60

Table 3.3 What you pay – Humana Walmart – Preferred Rx

Medicine Name Tier Initial Coverage Coverage Gap Catastrophic Coverage
Clobex LOT 0.05% Not on Formulary $821.61 $821.61 $821.61
Crestor TAB 10MG Tier 2: Preferred Brand $42.12 $80.02 $8.42
Diovan TAB 160MG Not on Formulary $139.52 $139.52 $139.52
Meioxicam TAB 15MG Tier 1: Preferred Generic $1.00 $8.04 $2.65
Metoprolol Succinate Er TAB 50MG ER Tier 1: Preferred Generic $1.00 $20.04 $2.65

Table 3.4 What you pay – First Health Part D Premier

As you can see from the tables above, the difference between tables 3.1 and 3.2 is the Clobex LOT costs during the Coverage Gap. AARP Medicare Rx Enhanced provides additional gap coverage for this drug; Blue Rx – does not. The difference becomes even more dramatic when we move to Humana Walmart (#6). Clobex is NOT on the formulary for this plan. Therefore, in all Part D stages, the full price of the drug is charged – $822.36. All plans starting from #6 and below have at least one drug that is not on the formulary. The more drugs are not on the formulary, the higher the cost. Compare total cost for First Health Part D Premier vs. Humana Walmart Preferred Rx. First Health has two drugs not on the formulary, and as a result, the total cost is $1,000 higher.

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How to Compare Medicare Part D Plans using Medicare Plan Finder

Medicare Part D Plan Finder – What should we learn from the analysis?

  • There is no better or worse PDP plan. The fact that in our particular study AARP Medicare Rx Enhanced was the least expensive is accidental. With different combinations of drugs or in different geographical areas, the result may be entirely different.
  • Use powerful analysis tools like the Medicare Plan Finder, or contact an independent agency like Liberty Medicare for help. It’ll cost you nothing, but you may save thousands of dollars.
  • Look for details of reports (like our tables 3.1-3.4). It will help you to understand the difference in total costs among different plans, and maybe make some adjustments in your list of drugs. It also will allow you to eliminate some plans as prohibitively expensive (perhaps because they do not have the medicine you need on the formulary).
  • Use your list and do not base your analysis on the Monthly Drug Premium. For example, the Humana Walmart plan has one of the lowest premiums ($18.50), and it is much more expensive for our drug list than AARP Rx Enhanced or Blue Rx Complete plans.

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Medicare Part D Plan Finder – US Government Sources

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