What's the biggest mistake seniors make when choosing a Medicare Part D plan?

Question

Timothy Brown · Accepted Answer

The 2 biggest mistakes that seniors make when choosing a Medicare Part D plan are:

1. Not verifying the listed prescription or tier level on the plan's formulary.

2. Enrolling in a plan where the monthly premium is excessive in comparison to the monthly cost of the prescriptions. Example: Paying a $103/month for plan for when you're only taking generic prescriptions.

Larry Dalton · Answer

With the changes made in 2025 to the drug formulas and tears, it is wise to analyze all the plans. Cheaper premiums could cost you more in the long run at the pharmacy. I would always investigate the drug plans each year.

Answered by Larry Dalton on April 17, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Joseph Meyers · Answer

Other than not talking to me first....a few possible mistakes could be made:

1. Not using medicare.gov to compare all plans against your medications. 

2. Not checking your drug coverage every year, by comparing new plans or if you were prescribed new meds

David Didier · Answer

Hello ,

On the Part D, (Prescription drug coverage).

 I get a list of your prescriptions you are currently taking, then I go to the Medicare.gov

I check what plans cover the drugs and the pharmacies at the lowest cost, so you can get the best prices and control the budget for your cost for the year!

It is best to check all your cost at the pharmacy you use, (it might be costing you a lot, or it might be the best, the Medicare.gov site lets you know, call me, I can help!

Thx!

Michael Pyers · Answer

They need to make sure that the Medicine is on the formulary of a plan before enrolling.
They also need to check for overall cost per Medicare.gov. They need to make sure that the pharmacy they use is covered and other options for Pharmacies are in the preferred network for the lowest cost for Meds.

Diana Salisbury · Answer

One mistake might be that they think that all copays are the same. Most plans require that a deductible be reached on Tier 3 and higher tiers before the cost of their expensive prescription is reduced.

Answered by Diana Salisbury on May 11, 2025

Broker Licensed in OH, IN & MI

Answered by Diana Salisbury Medicare Insurance Agent

Steve Brauer · Answer

Usually the biggest mistake people make when choosing a Part D Drug plan is they go for the cheapest alternative. Many Part D plans are very inexpensive, but if you look closely, the Prescription Drug list, or formulary, that they cover may be lacking or thin in some areas.

Answered by Steve Brauer on April 14, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Mel Stevens · Answer

By and far the biggest mistake is not electing Part D in a timely manner! Once you receive your part B effective date, Medicare will give you a 60-day window to elect a prescription medication plan. If you exceed the 60-day window, Medicare can and will penalize you for the rest of your life. It's very important to know these rules which unfortunately aren't explained or conveyed very well. Even if you don't take any medications, you still need to sign up for a Part D prescription medication plan. There are various Part D plans available in each state. If you don't take any meds or just perhaps a couple generics, tier 1 and tier 2 medications, there are some zero premium Part D plan available in Arizona. Premiums and formularies vary from company to company and plan to plan. It's important to check the formularies to ensure your meds are covered and to calculate your expected medication costs.

Answered by Mel Stevens on April 15, 2025

Broker Licensed in AZ

Answered by Mel Stevens Medicare Insurance Agent

David Christian · Answer

Getting a plan that doesn't have the prescriptions on the formulary. If you have a broker, this should never happen without you knowing the prescription wasn't covered beforehand and you are going into it asking for an exception from the carrier.

Answered by David Christian on April 8, 2025

Broker Licensed in CA & TX

Answered by David Christian Medicare Insurance Agent

Kerwyn Jones · Answer

Not checking the formulary to ensure all their prescriptions are covered. Also, simply forgetting to enroll within the time frame allowed for it

Joseph Lombardo · Answer

In my opinion, the biggest mistake seniors make when it comes to choosing a part D plan is focusing too much on plan premium. In addition to the premium, the senior should focus on deductibles, copays and the tier of prescription drug they're taking. When you focus on these items, you can get a much clearer picture of your yearly cost for your medications. I hope this helps.

Answered by Joseph Lombardo on May 5, 2025

Agent Licensed in NY, CT, NJ & PA

Answered by Joseph Lombardo Medicare Insurance Agent

Dan Calabrese · Answer

Looking at the cost of the monthly premium and the plan deductible without looking at the total cost when factoring in copays for medications. Also, assuming that they need to obtain the part D plan from the same carrier as their Medicare supplement.

Answered by Dan Calabrese on April 14, 2025

Agent Licensed in NY, CT & MA

Answered by Dan Calabrese Medicare Insurance Agent

What's the biggest mistake seniors make when choosing a Medicare Part D plan?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

What's the biggest mistake seniors make when choosing a Medicare Part D plan?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website