Residents of the Land of Lincoln have many ways to spend their retirement years—poring over Medicare prescription drug plans doesn’t have to be one of them!
You have many choices of prescription drug plans —more than 30! Choose from household names like Blue Cross and Mutual of Omaha to lesser-known insurance companies like Clear Spring Health. No single plan is right for everyone.
When you reach the eligibility age of 65 and sign up for Medicare coverage, you will need to decide how you want to get your prescription drug coverage. You can get it through a stand-alone Medicare Part D plan as part of Original Medicare or choose a more comprehensive Medicare Advantage plan.
Assuming that Original Medicare is the best option for your health needs, you will join the following parts:
Part A is insurance for inpatient hospital care.
Part B is medical insurance.
Part D helps cover your prescription drug costs.
Enrolling in a Part D plan is easy. You can select from any that are in your coverage area. Once you find plans in your city, you can compare them based on the prescription drugs you use, the monthly premiums, deductibles, and co-payments.
Ready to find the right Medicare plan for you? Use the Insurify Medicare comparison tool to explore Illinois Medicare prescription drug plans. Just enter your ZIP code, and you’ll be comparing plans in less than two minutes. Try it today!
Medicare beneficiaries in Illinois have a variety of options to choose from when it comes to Medicare Part D. Of the top eight PDP plans in Illinois, there are three four-star plans, all with monthly premiums of $25 or less. The remaining six plans have three and a half stars, with two deductible -free plans.
1. WellCare Classic
2. WellCare Value Script
3. WellCare Wellness Rx
4. AARP MedicareRx Preferred
5. AARP MedicareRx Saver Plus
6. AARP MedicareRx Walgreens
7. Blue Cross MedicareRx Basic
8. Blue Cross MedicareRx Plus
As you compare these plans, it’s helpful to know which tier your medications fall within to make an equal comparison. Remember that not all plans offer the same drugs. They are, however, required to cover medicines for every type of condition.
Monthly Premium: $25
Deductible: $445
Tier 1: $0
Tier 2: $3
Tier 3: $30
Tier 4: 35 percent coinsurance
Tier 5: 25 percent coinsurance
With an affordable monthly premium of $25 and some of the lowest prices on prescription drugs, it’s no surprise that this WellCare plan has a four- star rating. Tier 1 prescription drugs are $0, and Tier 2 is $3, the second-lowest among these eight plans. Once you max out your initial coverage, you pay 25 percent coinsurance for gap coverage.
Monthly Premium: $16.70
Deductible: $445
Tier 1: $0
Tier 2: $8
Tier 3: $43
Tier 4: 48 percent coinsurance
Tier 5: 25 percent coinsurance
At about half the price of its sister plan, WellCare Value Script offers similar pricing on prescription drugs. Tier 1 medications are $0, while Tier 2 is $8. As always, check the formulary to see which tiers your prescription drugs are in. If you take any that are in Tier 4, compare this plan with others, as it has 48 percent coinsurance, which is higher than the others.
Monthly Premium: $14.70
Deductible: $445
Tier 1: $0
Tier 2: $6
Tier 3: $41
Tier 4: 46 percent coinsurance
Tier 5: 25 percent coinsurance
At less than half the price of the top plan, also from WellCare, this offers similar co-pay and coinsurance rates. This might be the plan for you if your medications are in Tier 1 and Tier 2. It’s also a good one to go with if you don’t need a PDP yet but want to enroll in one to avoid the late-registration penalty.
Monthly Premium: $81.50
Deductible: $0
Tier 1: $5
Tier 2: $10
Tier 3: $45
Tier 4: 40 percent coinsurance
Tier 5: 33 percent coinsurance
With no deductible, this plan from AARP and UnitedHealthcare is excellent for those who want immediate access to low co-pays. But the monthly fee is steep, the second-highest of these top-rated healthcare plans.
Monthly Premium: $23.60
Deductible: $445
Tier 1: $1
Tier 2: $8
Tier 3: $37
Tier 4: 40 percent coinsurance
Tier 5: 25 percent coinsurance
For the low price, the AARP MedicareRx Saver Plus plan offers good value. The monthly premium is a modest $23.60, and co-pays are as low as $1 for Tier 1 drugs.
Monthly Premium: $32.60
Deductible: $445
Tier 1: $0
Tier 2: $6
Tier 3: $40
Tier 4: 40 percent coinsurance
Tier 5: 25 percent coinsurance
Earning three and a half stars, this offers solid value. Tier 1 drugs are $0, and the monthly premium of $32.60 is relatively low compared to the high-priced plans, which are twice as expensive or more!
Monthly Premium: $61.40
Deductible: $445
Tier 1: $1
Tier 2: $4
Tier 3: 16 percent coinsurance
Tier 4: 45 percent coinsurance
Tier 5: 25 percent coinsurance
When it comes to the monthly premium cost, co-pays, and coinsurance, this plan doesn’t look so great. However, this plan might be right for you if your medication isn’t on the formulary of other plans or if this one has a lower “full price.” This “full price” is a lower one negotiated between the manufacturer and your insurance company, not the full retail price.
Monthly Premium: $147.80
Deductible: $0
Tier 1: $0
Tier 2: $2
Tier 3: $30
Tier 4: 40 percent coinsurance
Tier 5: 33 percent coinsurance
This Blue Cross and Blue Shield of Illinois plan is the most expensive, at $147.80 per month, but it maintains a three-and-a-half- star rating. No deductible and free Tier 1 drugs make it an attractive choice. This plan’s Tier 2 and Tier 3 prescription drug co-pays are lower than any other plans’ included on this list.
Did you know that you can use the Insurify Medicare comparison tool to find the right Medicare prescription plan for you? Enter your ZIP code to see plans in your area. Try it now!
As a federal benefit to American seniors, Medicare is partially subsidized by the government, and enrollees are responsible for a portion of the cost. Private insurance companies run Medicare Part D prescription drug plans, so there’s no fixed cost. Each plan has its own fee chart, which can change annually.
Many of the Illinois prescription drug plans have monthly premiums under $50. These provide solid coverage. Some people choose higher-priced plans because they offer benefits that better fit their needs.
Your Medicare costs consist of several different expenses that depend on the plan you choose.
Monthly premium: Most prescription drug plans have a monthly premium. Generally, plans with premiums will have lower co-pays than premium-free plans.
Deductible: Until you meet your deductible, you pay the total insurance price of your medications. After reaching the deductible, you only pay the coinsurance or co-pay amount. Some plans have no deductible, but they may have higher co-pays and coinsurance.
Co-payments and coinsurance: After reaching the threshold for your deductible, you pay a fixed amount (for a co-pay ) or percentage (for coinsurance ) of the drug costs.
Other factors that will cause your Medicare costs to differ from your partner’s or friend’s include the medications you take and the service area in which you live.
Medicare prescription drug coverage is insurance coverage to cover the cost of medications. It works with Medicare Part A and Part B to provide well-rounded health insurance coverage.
If you have Original Medicare, you can choose a Medicare Part D prescription drug plan which helps with cost-sharing. Each plan will have a monthly premium, deductible, and list of co-pays and coinsurance for medications.
Medicare prescription drug coverage can be added to some Medicare Advantage plans that don’t offer this coverage as part of their plan. This only includes Private Fee-for-Service and Medical Savings Account MA plans.
Each year, your medication costs can vary depending on which phase of your plan you are currently in. Here’s a look at the three phases of the plans.
Initial Coverage Phase: This is the first $4,130 in medication spending each year. After you meet your deductible, you will pay according to the five tiers.
Gap Coverage Phase: After you exceed $4,130 and until your spending reaches $6,350, you pay 25 percent coinsurance on all generic drugs and brand name drugs. This fills the coverage gap left between the initial coverage and catastrophic coverage.
Catastrophic Coverage Phase: You qualify for this coverage level once your annual medication spending exceeds $6,350, considered the catastrophic level. You will pay a flat co-pay or 5 percent of the drug’s price, whichever is greater. The co-pay on generic drugs is $3.70 and $9.20 for brand-name drugs.
While you may get lucky and find a premium-free plan that suits your needs, not all plans are premium-free. The majority of them have a monthly premium in a range of price points. Remember that even the premium-free plans have other associated costs, like deductibles and co-pays.
The most important thing to know is which medications you take and where they fall among the tiers. You can then better compare the plans’ formularies and drug lists to see which one offers the best rates on the medicines you need.
Everyone who has Original Medicare is eligible to join a Part D plan. Even if you don’t need one now, you should get one because there is a monthly late-enrollment penalty if you join later. Consider choosing a plan with low premiums, even if you don’t need coverage now. It could come in handy, and it saves you money in the long run.
To get Medicare Part D coverage, you first have to be enrolled in Medicare. Signing up is simple. You can visit your local Social Security office or call 1 (800) Medicare. TTY users can contact 1 (877) 486-2048. Finally, you can visit Medicare.gov or www.cms.gov for the Centers for Medicare & Medicaid Services. They can also guide you on applying for the financial assistance program Extra Help.
With so many options for your PDP plan, narrowing them down can seem overwhelming. Once you have the list of available plans in your service area, you can consider these questions to help you choose the one that’s right for your needs.
Can I afford the monthly premium?
Do I want a no- deductible plan?
Are my medications covered?
Will I save money by choosing a plan with a lower monthly premium but slightly higher co-pays?
Which pharmacies can I use?
And remember, a plan is only a one-year commitment. If it turns out that the plan wasn’t as good as you thought, you can switch to a new one during the next Open Enrollment Period.
And don’t forget to compare plans and save money with the Insurify Medicare comparison tool. Uncover options in your area at no cost to you. Try it today!
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