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Medicare has a toll-free hotline and a Web site to help people sort through the new Part D drug coverage. Both options can be frustrating as well as helpful. If you want Medicare to help you compare drug plans, here are a few suggestions.
TELEPHONE
Medicare has hired 8,000 people to answer questions about the drug benefit and they are still learning their jobs. So when you call, try these tips.
1. Have your Medicare card and a list of all your medications handy. You will be asked for this information.
2. Call toll-free 1 (800) 633-4227. A woman's recorded voice will offer you some phone-tree options. Choose "drug coverage" as your first option.
3. After listing some pertinent dates, the woman will ask you to select either "enrollment" "information" or "publication." The fastest way to talk to a live person is to select the "enrollment" option. After giving Medicare some of your personal information, select "agent" the next time you have an option. That should connect you to a live person.
4. If you pick the "information" option, you may find yourself in a loop of various recordings. When you are ready to talk to a live person, either return to the main menu and start over when given the chance, or select the "status" option when you hear it and follow that by the "agent" option.
5. Tell the agent you want a list of stand-alone drug plans and their costs to you, based on your particular medications. Make sure the agent types in your specific medications before comparing plan costs.
6. If the agent asks if you want to limit your premium and deductible cost, say "no." It may sound cheaper to pick plans with zero deductibles or a low premiums, but those plans may cost you more in the long run because they cover fewer drugs. Tell the agent to compare all plans without restricting the premiums or deductibles.
7. When the agent lists three that seem to be the cheapest, write down what each plan will cost and get the company's telephone number.
8. Ask if those plans place restrictions on your drugs. If any plan restricts use of most of your drugs, discard that plan and add another one to your search.
9. Ask the agent to use the "lower my cost" option for all three plans to tell you how much you can save if you use suggested substitute drugs. Write down these possible savings so you can subtract them from the original cost of each of the three plans. Write down the names of any substitute drug to discuss with your doctor before you join a plan.
10. For the top three plans, ask the agent to tell you which pharmacies close to you accept that plan. Make sure each plan has at least one pharmacy you can use. If you are in a rural area, ask the agent to set the pharmacy finder option to 7.5 miles before giving you the pharmacy list.
11. Ask the agent to mail you a written brochure covering the information you have just discussed.
Pick a plan based on cost and easy access to your drugs. If your cost estimate includes substitute drugs, make sure your doctor approves that switch before you join a plan. Call your No. 1 plan to verify your cost estimate and that all your drugs will be covered. If those answers satisfy you, go ahead and enroll.
ONLINE
Be prepared to spend at least 45 minutes on this search.
1. Go to www.medicare.gov and click on "Compare Medicare Prescription Drug Plans."
2. About two-thirds of the way down the next page, click on the orange button next to "Find a Medicare Prescription Drug Plan."
3. Next page: Fill in your personal information in Section A and click on "search plans."
4. Next page: Fill in parts A, B and C and click on "continue."
5. Next page: Click on "choose a drug plan type."
6. Next page: Click on C "search for Medicare prescription drug plans."
7. Next page: Click on B "Enter your medications." (Do not click on C "limit your drug plans." If you do, the computer may exclude the best and cheapest plan for you.)
8. Next page: list your medications into A "find your drugs by name." When you are done, click on B "continue with selected drugs." Then click on C "choose my drug dosage." Then in A, use the drop down list next to each drug to enter your particular dosage. Then click on B "continue with selected drugs" then B "continue to plan list." (Skip the pharmacy option for now).
9. The next page lists the cheapest five plans in order of cost. If you want to look at more plans, go to the "plans per page" drop-down box at bottom right and select the "All" function. That will let you peruse all the plans more quickly.
10. To the right of each plan is a drop-down box. Go to the first plan and select "view cost details" in the drop-down box. This gives you a breakdown of how the cost of the plan is determined. Note that this screen also tells you how to save money by using a 90-day mail-order pharmacy. Also, see if any of your drugs have asterisks next to them. That means that the plan requires either prior authorization or step therapy for this drug (in step therapy the plan can require you to try a substitute drug first).
11. Go back to the plan list and click on "lower my cost share" in the drop-down box for the first plan. This lists possible substitute drugs and how they will lower your cost. If you click on each substitute drug, the computer will identify the substitute drugs so you can ask your doctor if you can safely switch to them. Compare your share of costs before accepting any substitute drugs to the costs you would pay if you did accept the substitute drugs. That represents possible savings you can subtract from the total annual cost of the plan.
Write down the original share of cost (the 30-day cost with no drug substitutes.) Now click on "Show Mail Order 90-day prices" at the top right. The next screen shows how you can lower your share of cost by ordering by mail. To arrive at a maximum cost savings, subtract the share of cost at the bottom right of this box from the original share of cost that you just wrote down (the one with no drug substitutes and 30-day cost).
12. Go back to the plan list and click on "# of pharmacies" next the first plan. This shows the pharmacies that will accept this plan. The list is pre-set to show pharmacies within 2 miles of your ZIP code. A drop-down box lets you widen that distance and add more pharmacy options.
13. Repeat steps 10 through 12 with each plan that interests you. Then contact the plans for full details of costs and any restrictions on your drugs. You can find plan phone numbers by going to the plan list and clicking on the plan name.
14. For more information on drug restrictions, go back to Medicare's home page and click on "Formulary finder." Follow that thread to the "plan list." In the "Plans per page" box at bottom right, change the "5" to "All" and scroll down to the plans that interest you. (All stand-alone drug plans will have "PDP" in the third column. Click on those plans for more information on how they restrict access to your drugs.)