UPDATED Mar. 16, 2019. 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 Plan using Medicare Part D Plan Finder – Analysis
Analysis
Drug List
Prescription Drug Plans
How much will you pay?
Drug List
The drug list used for the case study is shown in Table 1. It has several brand names (preferred or non-preferred). For drug lists like this, the difference between Total Annual Costs among different plans is very significant.
| Medicine Name | Quantity | Frequency |
| Atorvastatin Calcium, 10 mg | 30 | Every 1 Month |
| Breo Elipta Inh 100-25 | 1 | Every 1 Month |
| Fluticasone Nasal Spray. 16 GM | 1 | Every 1 Month |
| Januvia, 100 mg | 30 | Every 1 Month |
| Metoprolol Tartrate, 25 mg | 60 | Every 1 Month |
| Metformin HCL 1000mg | 60 | Every 1 Month |
Table 1. Drug List
List of Plans
We used the Medicare Plan Finder to get a list of available Medicare Prescription Drug plans (zip code 19116). There are 30 plans in 19116 to match our drug list. Their Total Annual Costs (actually, costs from March 15 through the end of the year) are in the range from $1,580 (the least expensive) to $5,840 (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 – CVS) |
Total Annual Costs (Mail Order) | Plan Rating |
| 1 | Silver Script Allure (PDP) | $80.00 | $0.00 | $1,580 | $1,532 | 3.5 out of 5 stars |
| 3 | EnvisionRx Plus (PDP) | $14.50 | $325.00 | $1,805 | $1,803 | 2 out of 5 stars |
| 17 | Humana Enhanced (PDP) | $73.70 | $0.00 | $2,208 | $2,074 | 3.5 out of 5 stars |
| 26 | Mutual of Omaha Rx Value (PDP) | $26.40 | $415.00 | $4,980 | $4,766 | Plan too new |
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 (Silver Script Allure) and #3 (EnvisionRx Plus) is about $250. However, the difference between #1 and #26 (Mutual of Omaha Value) is $3,400.
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 |
| Atorvastatin Calcium, 10 mg | Tier 1: Preferred Generic | $1.00 | $1.65 | $3.40 |
| Breo Elipta Inh 100-25 | Tier 3: Preferred Brand | $35.98 | $44.97 | $8.99 |
| Fluticasone Nasal Spray. 16 GM | Tier 2: Generic | $5.00 | $5.96 | $3.40 |
| Januvia, 100 mg | Tier 3: Preferred Brand | $49.98 | $62.48 | $12.50 |
| Metoprolol Tartrate, 25 mg | Tier 1: Preferred Generic | $1.00 | $1.30 | $3.40 |
| Metformin HCL 1000mg | Tier 1: Preferred Generic | $1.00 | $0.91 | $2.46 |
Table 3.1 What you pay – Silver Script Allure
| Medicine Name | Tier | Initial Coverage | Coverage Gap | Catastrophic Coverage |
| Atorvastatin Calcium, 10 mg | Tier 1: Preferred Generic | $1.00 | $2.93 | $3.40 |
| Breo Elipta Inh 100-25 | Tier 3: Preferred Brand | $35.00 | $90.07 | $18.01 |
| Fluticasone Nasal Spray. 16 GM | Tier 2: Generic | $6.00 | $5.49 | $3.40 |
| Januvia, 100 mg | Tier 3: Preferred Brand | $35.00 | $115.57 | $23.11 |
| Metoprolol Tartrate, 25 mg | Tier 1: Preferred Generic | $1.00 | $2.26 | $3.40 |
| Metformin HCL 1000mg | Tier 1: Preferred Generic | $1.00 | $2.05 | $3.40 |
Table 3.2 What you pay – EnvisionRx Plus
| Medicine Name | Tier | Initial Coverage | Coverage Gap | Catastrophic Coverage |
| Atorvastatin Calcium, 10 mg | Tier 1: Preferred Generic | $5.00 | $2.40 | $3.40 |
| Breo Elipta Inh 100-25 | Tier 3: Preferred Brand | $47.00 | $92.33 | $18.47 |
| Fluticasone Nasal Spray. 16 GM | Tier 2: Generic | $6.50 | $2.40 | $3.40 |
| Januvia, 100 mg | Tier 3: Preferred Brand | $47.00 | $118.56 | $23.71 |
| Metoprolol Tartrate, 25 mg | Tier 1: Preferred Generic | $5.00 | $2.40 | $3.40 |
| Metformin HCL 1000mg | Tier 1: Preferred Generic | $5.00 | $2.40 | $3.40 |
Table 3.3 What you pay – Humana Enhanced
| Medicine Name | Tier | Initial Coverage | Coverage Gap | Catastrophic Coverage |
| Atorvastatin Calcium, 10 mg | Tier 1: Preferred Generic | $5.00 | $3.22 | $3.40 |
| Breo Elipta Inh 100-25 | Not on Formulary | $385.20 | $385.20 | $385.20 |
| Fluticasone Nasal Spray. 16 GM | Tier 2: Generic | $5.97 | $2.21 | $3.40 |
| Januvia, 100 mg | Tier 3: Preferred Brand | $80.09 | $111.23 | $22.25 |
| Metoprolol Tartrate, 25 mg | Tier 1: Preferred Generic | $5.00 | $1.87 | $3.40 |
| Metformin HCL 1000mg | Tier 1: Preferred Generic | $4.70 | $1.74 | $3.40 |
Table 3.4 What you pay – Mutual of Omaha Rx Value
As you can see from the tables above, the difference between tables 3.1 and 3.2 is brand names costs during the Coverage Gap. Table 3.3 shows an additional factor of higher brand names costs during the Initial Coverage.
The difference becomes even more dramatic when we move to Mutual of Omaha Rx Value plan (Table 3.4). Breo Elipta is NOT on the formulary for this plan. Therefore, in all Part D stages, the full price of the drug is charged – $385.20. The more drugs are not on the formulary, the higher the cost.
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 Silver Script Allure plan 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 EnvisionRx Plus plan has the lowest premiums ($14.50), nevertheless, its total cost is higher than Silver Script Allure Plan whose premium is $80.00.
Medicare Part D Plan Finder – US Government Sources
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