Checking Part D Drug Costs Annually: Why It's More Than a Quick Price Lookup

When it comes to Medicare prescription drug plans (Part D), many people assume checking costs is straightforward - enter a medication name, review the price, and select the lowest cost plan. In reality, the process is far more nuanced. Overlooking key details can lead to unexpected expenses and higher out-of-pocket costs later in the year.

Prescription Drug Costs Change Every Year

Prescription drug plan are not static. From one year to the next, monthly premiums may increase or decrease, and annual deductibles can change. Carriers may also update their formularies, meaning the medications covered under a plan can shift.  In addition, drugs may be moved to different tiers, which can affect cost-sharing and overall coverage. Pharmacy networks may change as well, and new coverage requirements - such as prior authorization or step therapy - can be implemented without beneficiaries expecting them. For these reasons, a plan that worked well last year may not be the most cost-effective - or best - option going forward.

Getting the Details Right

​A thorough prescription drug cost review begins with accurate, detailed information. Estimates or generalizations can lead to incorrect comparisons and higher out of pocket costs over the course of the year. For the most reliable results, use the exact medication name, dosage, strength, quantity, and frequency, along with the pharmacy you actually plan to use. Even small differences, such as a change in strength or how often a medication is taken, can affect pricing and coverage comparisons.

Pharmacy Choice Matters More Than People Realize

Prescription drug pricing can vary significantly by pharmacy, even within the same plan. When reviewing costs, include your current pharmacy whenever possible, and consider comparing pricing across multiple pharmacies (up to five). Focus on the pharmacy that produces the lowest overall annual cost, not simply the lowest price on individual medications. In some cases, changing pharmacies can result in substantial savings over the course of the year; in others, remaining with your current pharmacy may be the most practical and cost-effective choice. 

Looking Beyond the Monthly Premium

A common mistake made among Medicare beneficiaries is evaluating prescription drug plans based solely on the monthly premium. A comprehensive review should also consider the drug deductible, estimated total annual prescription costs, cost differences by pharmacy, and how expenses may change over the course of the year.
Some plans appear inexpensive upfront but result in higher drug costs later, while others may have a higher premium but lower overall expenses. The objective is to evaluate total annual cost - not just the lowest advertised premium.

The Bottom Line

Reviewing prescription drug costs is more than a simple price lookup. It involves a careful evaluation of how your medications will be covered under your plan over time, and how that coverage may impact your total annual costs. That is why we encourage annual reviews - and why we take the time to explain what you are seeing - so you can make confident, informed decisions about your Medicare coverage. 

​To Get Help Now, Call Our Office!

​Rob and Carrie Davies
Prairie Grove Insurance
800-254-5200
​608-839-0275