Find Your Medicare Plan

Find Your Medicare Plan: A Step-by-Step Guide

Trying to determine which Medicare plan best meets your needs can seem confusing, but you can do this! Here are some tips to using the Plan Finder at www.medicare.gov.

1) Go to the official Medicare website, www.medicare.gov.

2) At the Medicare Home Page, CLICK the Health and Drug Plans tab on the left, and then CLICK on “Compare Drug and Health Plans.”

3) The next page starts the Medicare Plan Finder. Enter your ZIP code.

4) You have two options a. For a General Search you may skip past the green-lettered questions and CLICK the “Find Plans” button at the bottom. You will proceed with Step 1 of 4. b. Or, you may enter your Medicare information to do a Personalized Search. This option might make it easier to compare costs with the coverage you have now. Every line requires a response. Correctly answering these questions skips Step 1. CLICK “Find Plans” when you’re done.

5) Step 1 of 4: Enter Information for a General Search. An answer must be clicked for both questions. “I don’t know” will allow you to proceed, but it’s best to enter the information if you can. Clicking the (?) will get you an explanation of the topic. a. The first question is about your current coverage. (“Medicare Health Plan” means Medicare Advantage.) You may check more than one box. b. The second question is about limited-income assistance. This answer will set the calculation of estimated plan costs to factor in your subsidy, if you have one, so you will see the lower costs. CLICK “Continue to Plan Results.”

6) Step 2 of 4: Enter your Drugs (If you have already done this step and have “Saved List” information, you may enter it now in the box at the right and skip to Step 4.) You will need to know the exact name of all the prescription medications you take, as well as the dosage and the fill quantity (1 pill a day = 30 per month). Build your drug list by first typing in the name of one of your drugs, or click the alphabet letter to search the list. CLICK “Find My Drug,” and then scroll down to highlight the right one in the list that appears. CLICK “+Add Drug.” A box pops up. Select the dosage, quantity and frequency of your fill. CLICK “Add Drug and Dosage” and this one will become part of your list. Repeat for each of your drugs. Remember Note 2. It’s a good idea to write down the Drug List ID information now (you might want to change this date to your birthdate), then CLICK “My Drug List is Complete.”

7) Step 3 of 4: Select Your Pharmacies You may be able to skip this step by clicking “I don’t want to add pharmacies now,” but be aware that not all pharmacies contract with all Part D plans. If you prefer a certain pharmacy, or live in an area with few pharmacies, CLICK “Add pharmacy” at the appropriate name(s). Enlarge the range covered by altering the number of miles. CLICK “Continue to Plan Results.” 8) Step 4 of 4: Refine Your Plan Results Use the column on the left, “Refine Your Search.” Here you may set filters to include only plan information that will be relevant to you. You don’t have to set all of them. For example, in “Select Plan Types,” if you only want to see stand-alone (drug-only) plans, UNCHECK the other boxes for Health Plans, which are for Medicare Advantage, or vice-versa. CLICK the “+” or “–“ to expand or collapse sections. Down in “Select Drug Options,” it’s good to check the boxes for plans that cover all your drugs on their formulary and without restrictions. You can come back and change your filters later. CLICK “Update Plan Results,” then “Continue to Plan Results.”

9) Your Plan Results. Scroll down past “Your Current Plans” (if any) and “Original Medicare” to get to the list you actually want to see. The less expensive plan options are first. The drug total includes all possible related costs—premiums, deductibles, copays, coverage gap. Remember Note 3 above when going back a page.

10) Choose a plan to look at, and CLICK on the plan name. The green tab “Drug Costs and Coverage” will show how much each drug costs with this plan, and monthly totals. Compare Retail and Mail Order Pharmacy prices. Look at the bar charts. Important: Scroll down to “Drug Coverage Information” to see if the plan has any restrictions to access, such as quantity limits, a requirement for prior authorization, or step therapy. To find out more about a quantity limit, you may need to call the plan. Try to find the least expensive plan that covers all your drugs with no restrictions.

11) You can choose up to 3 plans at once for a side-by-side comparison. Put a check in the little box to the left of the plan names, and then CLICK the green arrow, “Compare Plans.” Again, look under the green “Drug Costs and Coverage” tab for the information, and use navigation buttons on the page or bread crumbs to go back.

12) If you have any questions call the prescription drug plan company’s toll-free number (listed in “Plan Details”), or Medicare at 1-800-633-4227; or talk to a Senior Health Insurance Benefits Assistance (SHIBA) certified counselor. SHIBA provides free, local, unbiased help with Medicare. Contact the SHIBA helpline at 1-800-722-4134.

13) If you can do this, think about becoming a certified SHIBA to help others in your community. Call us—we’ll train and support you!

14) When you have your questions answered and have found the plan that best fits your current needs, enroll either on line or by phone, either with Medicare, SHIBA, or the company.

Note 1: Medicare periodically makes changes to the Plan Finder. You may find some steps will need to be altered slightly or even eliminated. Note 2: Beware that your session can time out. You may have to start over. Good idea to write down the “Retrieve My Saved List” ID codes before you end Step 2. Note 3: Navigate within your page by choosing “Return to previous page”-type buttons. Using your browser’s Back button may kick you out of the Finder. Now there are also “bread crumbs” across the top of the page you can use to choose another page to skip back to.

Rev. 8/4/11