GoodRx: Medicare Part D plans cover smaller percentages of available drugs, more likely with restrictions

Our broker tells us that unless you know the name of the drug you maybe-might be prescribed, there is no way to know what might be best. From the government Medicare site: The formulary includes at least 2 drugs in the most commonly prescribed categories and classes. This helps make sure that people with different medical conditions can get the prescription drugs they need. All Medicare drug plans generally must cover at least 2 drugs per drug category, but plans can choose which drugs covered by Part D they will offer. If a particular drug isn’t listed, your doctor can request an exception in order to get them to cover that drug (I’ve seen reports of that working and not working, so YMMV). The discount programs like GoodRx and SingleCare might have good prices. There may be programs your doctor knows about, as well. You can change your plan for the following year - at least they gave us that possibility.

I tried plugging in some drugs to various plans to see if they’d be covered. The $0 Wellcare plan didn’t seem any worse than some higher price plans. If you already are taking high priced drugs, you may actually find that a higher price plan costs you less than the $2,000 cap due to the very convoluted way the cap is calculated.

In other words, it’s pretty much a shot in the dark unless you already know what drugs you might be prescribed in the coming year.

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