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Consider factors besides cost for Medicare Part D plan

BELLEVILLE, Ill. — Medicare Part D plans with the lowest premiums may not be the best match for Medicare beneficiaries’ individualized needs, according to Allsup, a nationwide provider of Social Security disability representation and Medicare plan selection services.

More than 1,100 Medicare prescription drug (Part D) plans are available for 2011. Most consumers have about 33 plans to choose from in their area during annual enrollment, which ends Dec. 31.

“People tend to look at the Part D plan’s premium because it’s the easiest thing to compare, but it’s not necessarily a realistic reflection of the true cost,” said Adrienne Muralidharan, senior Medicare specialist for the Allsup Medicare Advisor®.

“Looking only at the prescription drug premium is like looking at a car’s sticker price. The cheapest car could have awful gas mileage, excessive maintenance costs and a design that does not match your needs,” Muralidharan said.

Key questions to ask when evaluating Part D plans include:

1. What are all the costs involved? In addition to the premium, these costs can include deductibles and co-payments.

2. What drugs does the Part D plan cover? Determine that the plan covers your medications, taking generics and brand name drugs into account.

3. Does the plan restrict where or how you can purchase medications? Look at preferred and non-preferred pharmacies. You may have to pay higher rates if you don’t go to a preferred pharmacy.

4. Is having coverage during the gap (“donut hole”) necessary? The prescription drug gap in coverage occurs in 2011 after the individual’s and plan’s combined costs total $2,840. After that amount is reached, the person is responsible for all costs until catastrophic coverage starts. For 2011, beneficiaries do receive some relief from a 50 percent discount on brand drugs and 7 percent discount on generic drugs bought while they are in the donut hole.

However, not everyone who falls into the donut hole would benefit from purchasing a more expensive Part D policy with gap coverage, according to Muralidharan.

5. Do you have comprehensive and objective information on the plan? Consider using a Medicare plan selection service that is not designed to promote a specific plan, including one provided by a specific insurance provider.


Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers.

Source: Business Wire


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