Plan Comparisons

How do you choose from so many plans?

Whether you are a new or current Medicare enrollee, you will need to make a choice about which plans you need to maximize your healthcare coverage. To help you narrow down your choices, Medicare has a Plan Finder tool.

If you have original Medicare

You will need to choose a Medigap plan and a Part D Prescription Drug plan to supplement your coverage.

Finding a Medigap Plan

1. Watch the Medicare video about Plan Finder.
2. Go to the Medicare Plan Finder and enter your information.
3. Decide which of the 10 standardized plans (summarized in our Medigap Plan Chart) you want depending on how much coverage you need or want.
4. Determine what type of age-based premiums provide the best value over your lifetime: attained age, issue age, or community-rated.

Medigap Finder Results

The Medigap Plan Tool lists all the plans offered in your area by Plan. From this list, choose your Plan (i.e., Plan G), then click on the View Policies button to show:

• Insurance companies offering the plan
• Type of age-based premium, and
• Company contact information

Use this information to choose your Medigap plan and insurance company.

Finding a Part D Prescription Drug Plan

1. Watch the Medicare video about How To Use Medicare’s Plan Finder.
2. Go to Medicare Plan Finder, select Drug Plan (Part D), and enter your information, including:
   • Zip code
   • Assistance you receive
   • Prescription drugs you are currently taking, and
   • Pharmacies you use

Medicare Plan Finder Results for Part D

After you have entered your information, the Medicare Plan Finder shows all the available Part D plans available in your area. The plans are sorted by the total lowest drug and plan premium cost for the year. You should carefully review each plan you are interested in for:

• Step Therapy
• Prior Authorization
• Coverage for all your prescribed medications

If you take a brand name prescription medicine, check the Plan Details button to see if the Part D plan requires Step Therapy.

Step Therapy means that the plan may require you to first try another drug before it will pay for the specific drug prescribed by the doctor.

Prior Authorization means that you need approval from the prescription drug plan before the prescription drug cost is paid by the plan. Your doctor must contact the plan and show it is medically necessary for you to use that particular drug.

You also want to check to see if all your prescriptions are covered under the plan before you decide.

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If you have Medicare Advantage (Part C)

You would also use the Medicare Plan Finder to compare your current plan to next year’s plans.

Comparing Medicare Advantage Plans

1. Watch the Medicare video about How To Use Medicare’s Plan Finder.
2. Go to Medicare Plan Finder, select Medicare Advantage (Part C), and enter your information, including:
   • Zip code,
   • Assistance you receive,
   • Prescription drugs you are currently taking, and
   • Pharmacies you use
3. Use Filters to see only those plans that offer features you want, such as Vision, Dental, Prescription Drug, or Insulin.

Medicare Advantage Plan Comparison Results

Plans are sorted automatically by the lowest drug plus premium cost. You’ll see your estimated yearly drug plus premium cost, if the Medicare Advantage plan includes drug coverage.

You will also see other costs, like deductibles, co-pays, and yearly maximum out-of-pocket amounts for health services. To get more details about a plan, what’s covered, its costs, extra benefits, in- and out-of-network pharmacies, just click on the blue button, “Plan Details.”

There are costs that are not included:

• Part B premiums (you must be enrolled in Medicare Part B and pay your monthly premium)
• Co-pays
• Deductibles
• Other costs for health services