Step-by-Step Guide: Choosing Your Medicare Part D Plan

Choosing Your Medicare Part D Plan

A Step-by-Step Guide

Follow the steps below to enter your medications, review options and find the Part D plan that best fits your needs.

Before You Get Started

Recent changes to Prescription drug plans have affected how insurance agents can assist clients.
Most insurance carriers no longer allow agents to assist with enrollment or servicing of standalone Part D plans.
Because of this, clients must enroll directly through Medicare.gov or the insurance company.
HTA created this guide to help you navigate the process.
While we do not receive commissions for Part D plans— we’re happy to answer any questions before you complete your enrollment.

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Information to Gather

Before you go to the Medicare website, have these items sitting next to you:

1. Your Medicare Card (You’ll need your Medicare Number and start date)
2. Your current Prescription Bottles
3. Name(s) of your Preferred Pharmacies

Tip: Using the exact medication name and dosage helps Medicare.gov estimate the most accurate costs.

Step 1: Create Your Medicare.gov Account

Once you receive your Medicare number, you should create a Medicare.gov account. This allows you to save your prescriptions and compare drug plans accurately.

Steps to create your account:

1. Go to www.Medicare.gov
2. Enter your Medicare # and Start Date
3. Follow the steps to create a username and password
4. Complete the account verification process

Step 2: Add Your Prescriptions

Steps to enter medications:

1. Click Health & Drug Plans at the top of the page
2. Select Find Health and Drug Plans
3. Under Your Drug List, click + Add a Drug
4. Begin typing the name of your medication
5. Select the correct dosage and how often you take the medication
6. Click Add to My Drug List
7. Repeat this process for all active prescriptions

Tip: Using the exact medication name and dosage helps Medicare.gov estimate the most accurate costs.

Step 3: Choose Your Pharmacy

Once your medications are entered, Medicare.gov will ask you to select a pharmacy. Prescription drug costs can vary depending on the pharmacy used.

Steps to add pharmacies

Enter your ZIP code
Search for your preferred pharmacy
Select the pharmacy you typically use

You can select multiple pharmacies to see which one offers the lowest cost for your medications.

Step 4: Compare Plans by Total Annual Cost

1. Review the list of available plans, sorted by lowest drug + premium cost
2. Click “Plan Details” on the lowest cost options to see how each of your specific medications is covered.
3. Print or Save to PDF the Plan Details Page of the lowest annual cost plan

Focus on “Total Drug & Premium Cost” — not just the monthly premium.

Step 5: Review Plans with Your HTA Advisor

After comparing plans on Medicare.gov, note the plan with the lowest estimated annual cost.
At your next appointment, your HTA advisor will review:
- - The medications you entered
  - The plans you’re considering
  - Any questions about cost or coverage

Once the plan is confirmed, you will complete enrollment directly through Medicare.gov.

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What to Expect During Annual Enrollment (AEP)

Annual Enrollment Period: October 15 – December 7

During this time, you can review and change your prescription drug plan for the following year.

What Can Change: Premiums, deductibles, covered medications (formulary) and pharmacy networks

How HTA Supports You During AEP:

- Keep you informed on key changes in the Part D landscape
- Communicate any major updates to your current plan
- Provide videos and step-by-step guides to help you review your options on Medicare.gov

Reviewing your plan each year helps ensure you continue to have the most cost-effective coverage.

AEP symbol. Concept words AEP Annual enrollment period on . Medical and AEP Annual enrollment period concept

Important Tips

While Entering your Medications

Enter medications exactly as prescribed
How should I enter “as needed” medications?
Medicare.gov may not calculate costs accurately for medications you only fill occasionally, and the “every 2 months” and “every 6 months” options often produce misleading estimates.

To get a more accurate cost per fill:

If you fill a medication 4–5+ times per year, enter it as monthly

If you fill a medication 1-3 times per year, enter it as every 12 months

Example:
If you take a medication as needed and fill it a few times per year, entering it as monthly may increase the total annual cost shown—but it will give a more accurate estimate of your copay per fill.

Note: The total cost shown may not reflect what you actually spend, but this method helps you compare plans more accurately.
This is only a pricing tool—not a commitment

Adding a medication to Medicare.gov does not mean you will have to fill or pay for that prescription.

This tool is only used to estimate your costs. You are only charged for medications you actually fill at the pharmacy.
Your medication list is not reported to the insurance company.
What if I use GoodRx or pay cash?
You can still enter those prescriptions into Medicare.gov to see how each Part D plan would cover them.

This helps you compare:

Whether the drug is covered

The estimated copay

Any deductible

Any restrictions, such as prior authorization or quantity limits

You are not required to use your insurance for every prescription. At the pharmacy, you can ask whether the cost is lower through your Part D plan, GoodRx, or cash pricing.

Important: Prescriptions filled outside your Part D plan do not count toward your Part D deductible or annual out-of-pocket costs.

Tip: If a medication is expensive or taken regularly, enter it into Medicare.gov even if you sometimes use GoodRx.
Some medications are covered under Part B, not Part D
Medications given in a doctor’s office are usually covered under Medicare Part B, not Part D.

Examples include:

Prolia injections

Cortisone injections

Infusion treatments

These do not need to be entered when comparing Part D plans.
Over-the-counter medications are usually not covered

When Comparing Plans

Your pharmacy choice affects your cost
Plans classify pharmacies as preferred or standard.

Preferred pharmacies typically offer lower copays

Many plans allow 90-day supplies at retail or mail order

Mail order is not always the lowest-cost option

Comparing multiple pharmacies can help you find the best pricing.
Deductibles and How They Work
Some Part D plans include a deductible, which is the amount you pay out-of-pocket before the plan begins covering certain medications.

However, most plans that have a deductible do not apply it to lower-tier medications (Tier 1–2). This means:

You will typically pay just the copay for those medications

The deductible usually applies to higher-tier (brand-name) drugs

Because of this, having a deductible does not always mean higher overall costs, especially if most of your medications are lower-tier.

Your HTA advisor will review how the deductible applies to your medications before you confirm your plan.
Drug tiers affect your cost
Each plan places medications into tiers (typically Tier 1–5), which determine how much you pay.

Tier 1-2 : Lower-tier drugs (usually generics) have lower copays

Tier 3-5 : Higher-tier drugs (brand-name or specialty) have higher costs

Two plans may cover the same medication but place it in different tiers, which can significantly change your cost.

When comparing plans, check how your medications are categorized, as this directly impacts your total annual cost.
Focus on the total annual cost

When comparing plans, the most important factor is the total estimated yearly cost, not just the premium or deductible.

The total estimated yearly cost includes; Monthly premiums, Deductibles and Copays for all entered medications.

All plans have a maximum annual out-of-pocket limit for prescription drugs. This is the most you will pay in a year for covered prescriptions, including your deductible and medication costs.

The goal is to choose the plan with the lowest overall cost based on your prescriptions.