What's the biggest mistake seniors make when choosing a Medicare Part D plan?
Answered by 73 licensed agents
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.
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.
Always be s ure your medications are in the formulary, make sure your pharmacy is a preferred pharmacy, and use medicare.gov or heymoe.com to get an independent view before you enroll
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.
The biggest mistake that seniors make when choosing a part D plan is to choose a plan strictly for the price of the plan , rather than taking in consideration the cost of the drugs, and the premium.
The right thing to do in order to get the best fit for you, is to contact your insurance agent, let them know what drugs you take including the strength and let them figure out which plan is the best plan for you after analyzing all the information.
I can’t really address the mistakes as much as how to pick one. When you are looking for a Medicare prescription drug plan first look at the deductible on the plan you are looking at.
Next, check all of your meds to make sure they are covered and what tier they fall under. Don’t assume that each plan will cover your meds. Each plan has a different list of medications or formulary.
Next know how much each medication would cost you each month. Also know what the monthly premium is.
Don’t assume that a plan that charges $0 premium is going to be the cheapest plan for you.
Lastly, check to see if your pharmacy is in the network. Plans also have a mail order pharmacy and on some plans you can save money by using them and they come right to your mail box.
Medicare agents have a resource for seniors, and we're happy and proud to be a part of giving the answers. What's the biggest mistake seniors make when choosing a Medicare Part D plan? Simple, they don't search out all of the options that are available on an annual basis for the Part D plans. The Part D plans change every year, just like Medicare Advantage, so you want to look at what options are out there.
What we do here at my State Farm agency on Kelly Street in Manchester, just like I did for my free appointment today, is we go on and look at the different options that are available. For the four medications that she was taking, the plans ranged from zero premiums to $51 a month for the same plan to cover the same prescriptions.
So work with someone like myself who's going to do that extra homework for you and make it work for you. Please work with someone like myself who will help you with that. We'll do all the legwork, and then any time every year you have to renew, we look at what's out there now, and we can help you with that. We'd be honored to help you. Thank you.
The biggest mistake is not actually running your medications on Medicare.gov or having an agent run them. Medicare.gov is an unbiased comparison. But there can be errors on Medicare.gov so be careful. Using the Medicare and You book is never a good way to choose a plan.
Buyin a plan based on monthly premium instead of overall yearly cost? Why does this happen? Usually because the average person does not know how to do this properly. Many seniors may qualify for extra help and not know it. Let a professional run your formulary and get what your actual cost will be.
I think it is assuming that the most expensive, stand-alone part D (prescription drug plan) is the only plan to cover their medications. Often we find that the zero dollar premium and low cost part D plans cover most drugs.
Before you overpay for a Part D plan, consider verifying your medications are on the plan's formulary for the year and compare the cost for the medications. When carriers have more than one Part D plan available, they can also have different cost share (co pays, coinsurance, and deductible requirements) and categorized in different tier levels that will impact your out of pocket cost for your medications.
If you need help, reach out to a local, trusted, Medicare advisor, SHIP, or visit the Medicare.gov website for more information, best practices, and resources to help you assess and compare your options for the upcoming year.
One of the biggest mistakes is choosing a plan based solely on the premium and not factoring the out of pocket costs and pharmacy or pharmacies that will be used.
A Medicare beneficiary will want to check to see if their preferred pharmacy is in the network for the Part D Prescription Drug Plan. Each insurance carrier will have different preferred pharmacies within their network.
It is important that one identifies the correct prescription that will be taken when reviewing the formulary under the plan. It can make a difference if reviewing tablets versus capsules or brand name versus the generic option.
It is important to review the Part D plan annually as your needs may change with prescriptions, and the plans change annually. Premiums, deductibles and copays can shift each year. Also, prescription formularies can change tiers from year to year.
Also, it is a great idea to have a discussion with the medical professionals who prescribe prescriptions to identify which medications would work well to treat you and what options could potentially save you money.
It is always good to look at the bottom line. You always want to look at the total estimated costs rather than which plans offer you the lowest premium.
With continual changes in Carrier Plans, Formularies, and Deductibles, choosing the right Medicare Part D plan is getting more challenging each year. Below is a quick summary of the four biggest mistakes seniors make when choosing a Medicare Part D plan.
1) Not comparing plans: The biggest mistake is not comparing plans. This is critical to ensuring you are on the right plan to start out with, and each year during the annual enrollment period (AEP), because plans change annually. You must not assume that your plan will remain the same year to year. This goes for both Medicare Part D and Medicare Part C plans.
2) Not considering your prescriptions: Some plans may have a low premium, but your prescriptions may not be covered in that carriers formulary. Carriers may change their formularies each year, so this comparison should also be done during initial enrollment as well as each year during the AEP.
3) Not considering deductibles, copayments, and in network pharmacies: In 2026, several carriers added or increased their drug deductible and copays. In addition to considering these elements you should also ensure that you are using an in-network pharmacy. Not doing so could cost you several hundred dollars per prescription. All of these costs vary from carrier to carrier and many of these costs will change annually.
4) Missing enrollment periods: Missing your initial enrollment period in Medicare Part D or missing the annual enrollment period are key mistakes that seniors make. Seniors that are turning 65 or currently on a Medicare Plan, should work with a local broker at least 3 months in advance of their 65th birthday and each year during the AEP, which is October 15th-December 7th.
The biggest mistake one can make when choosing a part D plan, is to simply choose based on cost of premium and not taking into account the drugs and tiers coverage in the formulary
The biggest mistake is choosing a Part D plan based only on the monthly premium instead of checking how their specific medications are covered. A plan that looks cheap upfront can end up costing much more if their drugs are in a higher tier, require prior authorization, or are not covered well at their preferred pharmacy. The best plan is the one that fits their actual prescriptions, pharmacy, and total yearly cost, not just the lowest premium.
In my opinion, the biggest mistake seniors make with their Rx plan is not changing it once they enroll. AEP has an important function for Medicare beneficiaries, and that open window ensures that when the drug and advantage plans change (as they do annually) they are not stuck in a plan that no longer works for them.
The biggest mistake is picking a plan based on its low premium rather than how it covers your medications. It is also very important to review your prescription drug plan every year during the annual enrollment period from Oct. 15 through Dec. 7.
The biggest mistake you can make is not looking up all of your drugs to make sure they are on the carriers formulary. Also, basing your decision on the monthly premium alone, is a common mistake people make, especially if they have tier 3 - tier 5 drugs.
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!
You need to make sure all your formulary prescriptions are covered under that part D plan. There is away for us to check that. Certain prescriptions do fall under Part B.
There are 2 important points in choosing a Part D plan: 1) use Medicare.gov to see how each plan works with your prescriptions, and 2) understand that almost all of the plans have a deductible either on all tiers or on tiers 3/4/5.
Not knowing that a Part D drug formulary can be changed to eliminate your drug anytime during the year. Naturally, this is outrageous! It will happen with brand name drugs due to the volatility of all Rx's nowadays. I feel that this is THE biggest challenge facing seniors today.
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.
By not checking if your medications are on the plans formulary. Or deciding that you do not need a part D plan because you don’t currently take medications.
They don’t work with an experienced agent that knows how to do the proper research by getting the seniors medication. The proper research is done to find the most favorable Part D plan at the lowest cost and lowest monthly by premium for the drug plan.
Without a doubt the BIGGEST and the MOST COSTLY mistake Sr's make when they are eligible for Part D is to NOT take it "because I don't take any medications". When opting out of this you are setting yourself up for "forever" LEP (Late Enrollment Penalty) down the road. The Medicare Part D LEP is calculated at a 1% penalty for every month you were eligible for Part D and you DID NOT enroll. This 1%/per month is based on the national average cost of a Part D drug plan and a.) stays with you forever b.) recalculates every January to new "national average".
The second biggest error is enrolling in a plan when turning 65 and having the monthly premium deducted from your monthly SS check. Over time, both plan premiums and member drug needs change and this is something that needs to be reviewed every year during AEP.
Most areas in the country will have $0 to low cost stand-alone PDP plans so do yourself a favor and don't bypass this when you are first eligible.
NOT CONSULTING WIYH A LICENSED MEDICARE AGENT. WORKING WITH SOME RANDOM PERSON FROM A CALL CENTER. NOT CHECKING MEDICATIONS AND MAKING SURE THEIR PHARMACY IS PREFERRED. (IN NETWORK)
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.
It is important to choose a Part D plan even if you are healthy when you turn 65. If you delay your application, you will incur a penalty and have to pay additional premiums. Furthermore, the penalty will continue.
One of the biggest mistakes seniors make when choosing a Medicare Part D plan is they don't check all their medications on the plans before making a decision. They only check the one or two they are concerned with. Another mistake they make is not checking different pharmacies on the plan and compare costs between the pharmacies.
The two major mistakes people make when choosing a part D plan would be not getting one at all because they take no medication‘s or not searching their medication’s amongst all plans offered in their area. The best place to search your medication’s with your pharmacy is on medicare.gov. While agents don’t enroll Members any longer, they can certainly be a helpful guide when looking for a Medicare part D plan.
One of the biggest "mistakes" I see seniors make regarding Part D coverage, is not comparing plan costs for their individual needs. I always suggest to review all plans in your area to see what your total out of pocket costs will be based on your prescriptions.
The biggest mistake seniors make when choosing a Medicare Part D plan is not reviewing their options annually, especially during the Annual Enrollment Period (October 15 to December 7). Many seniors stick with the same plan year after year without considering changes in their needs, plan coverage, or available options, potentially leading to higher costs or inadequate coverage.
They do not have a medicare insurance consultant verify the cost of their medications prior to signing up for a prescription drug plan (Part D) and get hit with high cost of medicines. Or have a High Rx deductible.
Price versus total cost benefit. Just because a company may have the cheaper premium doesn’t mean it’s the best. A higher price Psrt D may cover overall drug costs better
They don't make sure all of their medications are covered, they say they only take 1 or 2 medications, and then the agent signs them up for an inexpensive plan that doesn't cover all of their medicines. The Agent needs to verify all of the seniors medicines are covered at the least expensive cost for them, and then when you add the meds, the agent should still be able to tell you the most cost effective plan available to you over the course of a year, not just a month.
The major mistake to avoid is to ensure that all your current prescriptions are covered and that the company's formulary includes the medication. You also have to make sure that these prescriptions and cost fit your budget. Make sure the proper plan covers all out-of-pocket costs. Zero-dollar or low-cost PDP plans are not always the best option.
Most get talked into the most expensive plan because they believe its the best plan. They also dont know they can change them every year. I check every year for my clients their Part D plans to make sure they are on the best one for them and their prescriptions. They can save hundreds of dollars just having it checked every year.
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.
An agent can help seniors better understand a Part D plan formulary and how it aligns with their specific medication needs. It is also important not to overlook coverage restrictions like prior authorization or tiered drug costs, which can lead to unexpected expenses or inability to access necessary medications.
Hello, Robert Remin, Expert Medicare Plan Advisor, licensed and Medicare and Carrier certified in New York, Connecticut, New Jersey, and Florida. The biggest mistake people make when they try to choose a Part D prescription drug plan on their own is assuming the higher premium they pay, the lower the drug costs are. That is not necessarily the case. There's no reason to pay a large premium to a carrier if you are taking all generic drugs. It makes absolutely no economic sense. Some people do that in anticipation, thinking, "Oh, one day I'm gonna wind up with an expensive drug, so I need to pay the bigger premium now, so in case I wind up with an expensive drug, it will be less." That is the completely incorrect way to think about choosing a Part D Medicare plan. If you have additional questions, please call or text me.
Consider getting a bird’s eye view of every Prescription Drug Plan in your area if you have a Med Sup before purchasing the first thing or recognizable name.
If you have a Med. Advantage plan, consider getting a plan that has a prescription drug plan already attached whose Drug Formulary supports the prescriptions you take.
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.
The biggest mistake made is not taking into account you monthly premium plus you drug costs. The other mistake is if you are on high priced name brand or new drugs.
The biggest mistakes would be not checking all of your medications on the plan's formulary. Allowing your plan to auto-enroll each year at potentially increased costs instead of completing an annual plan review during your annual enrollment period. Reach out to a licensed sales agent to assist & walk you through the process. Just cause the monthly premium is lower, it doesn't mean that your costs will be low.
The simplest way I can put it. The one thing that they do is looking to choose plans on their own. Get an agent or broker that can do the research for you.
The biggest mistake is to not check the formulary for every medication prescribed. Formularies change so often, it’s imperative to check them constantly.
The biggest mistake seniors make when choosing a Medicare Part D plan is that they go by company names that they know instead of analyzing the whole marketplace, AND finding a PLAN THAT WILL ASK FOR THE LEAST AMOUNT OUT OF THEIR POCKET.
What's the biggest mistake seniors make when choosing a Medicare Part D plan?
You should have an Agent do a proper needs assessment to make sure all of your medication is covered and review alternative options to meet your needs and budget.
The biggest mistake seniors often make when choosing a Medicare Part D (prescription drug) plan is not reviewing and comparing plans annually based on their current medications.
The biggest mistake in my opinion is just going by the monthly premium price. Even though it is not required, they should always make sure all of their prescriptions are covered. Drug formularies may not only differ between carriers, it can also differ between plans with the same carrier. Also, make sure their preferred pharmacy is in-network or that they at least have an in-network pharmacy close to them.
The biggest mistake I have seen is enrolling in a prescription plan (PDP) solely based on the monthly premium cost. Without actually evaluating a plan with a person's current, or known future prescriptions, it is possible to have to pay for 100% of the cost of the prescriptions. Not all prescriptions are on every formulary, nor are they all valued the same on the different formularies.
They go with something recommended by a friend, and not the best plan for them based off of the meds they take. It is best to compare all the options available in your state.
Not verifying that their medications are on the formulary and at the lowest cost. Also verify what Pharmacy is preferred and which ones aren't as that has a lot to do with the pricing.
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.
One of the biggest mistakes is not checking to see if the drugs are in the carrier's formulary and what the cost will be. Never assume all carriers offer the same benefits. Talking to a trusted Broker who care about their clients and goes over details will help save money down the road.
The biggest mistake seniors make when choosing a Medicare Part D plan is focusing only on the monthly premium without checking whether their medication are covered or how much they'll actually pay out-of-pocket. Why this is a costly mistake?
Many seniors are drawn to the lowest premium plans, assuming they'll save money. But:
Look out for limited drug coverage with low premiums, pharmacy networks, and hidden costs.
Not checking beforehand if their prescriptions are in the formulary of the plan they’re looking to get. That’s why it’s so important to have an agent help you you get the plan that Best suits you and your needs.
I as an insurance agent helped my Medicare members by educating them on what the options are before we start looking at any plans this way we ensure getting the right fit for you.
The biggest mistake would be to not enter your current prescriptions into the carriers drug lookup tools. It is very important all current prescriptions are in the plan's formulary, and know what your cost share exposure is.
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.
The biggest mistake seniors make when choosing a Medicare Part D plan is just leaving it to be paid annually and not looking at the changes year to year. The formulary often can change from and could be costly on some medications. Its always a good rule of thumb to re-evaluate.
Not reviewing your medications annually is the biggest mistake Seniors make when choosing their Part D plan. Plans can change their formularies, which could affect coverage and costs, in turn costing you time and money.
When it comes to Medicare part D plans, I feel the biggest mistake. People make is not reviewing them each year. It’s critical as the plan rules change, and people’s medication‘s list can change.