Picking a Part D plan based on premium alone is one of the most common — and most expensive — mistakes I see. A low premium often hides higher copays or restrictive formularies.
1. Are all of my medications on the plan's formulary? If a drug isn't covered, you pay full price.
2. What tier is each of my drugs on? Tiers determine your copay, and the same drug can sit on different tiers across plans.
3. Is my preferred pharmacy in the preferred network? Preferred pharmacies often have substantially lower copays.
4. Are there any coverage restrictions like prior authorization, step therapy, or quantity limits?
5. What will my total annual cost be — premium plus expected copays — not just the monthly premium?
Answering these five questions takes about 15 minutes together and often saves hundreds of dollars a year.