Last year’s Medicare Open Enrollment season, my husband, Steve and I changed from our Medicare Supplement Plan with a separate Part D plan to a Medicare Advantage PPO plan.  We were told that our doctors were in the plan and all of my husband’s diabetic meds were covered. Which was not true! Because one diabetic prescription was not covered by his plan. 

To make matters worse, now my husband’s diabetic doctor is no longer in the plans network and has directed us to enroll in a Medicare Supplement with a prescription drug plan.

Most of his prescriptions are generics that now have a with a simple copay and we are concerned that Sid will dive into the “famous” Medicare donut hole because he now is taking Xarelto for his heart and 2 brand name insulins for his diabetes. How do we know which is the right Medicare Part D plan for him?

Please guide us to find the best plan to fits our prescription drug needs and not financially break us. 


Margie from Pampa

Great question, Margie:

The first topic discussed at a Medicare consultation in the Toni Says® office is what Medicare Part D prescription drug plan or plans cover all your prescriptions. Most do not realize that all medications are not covered under Medicare Part D formularies.  When not covered, one must pay 100% out of pocket.

Searching for the right Medicare Part D prescription drug plan that fits your needs is vital to proper Medicare planning.

Steps to do your own Medicare Part D prescriptions drug planning and find which plan best fits your prescription drug needs are below:

  1. Go to
  2. Click on the first green box which says “Find health & drug plan
  3. Put in your zip code and click “Find Plan” box.
  4. Step 1 of 4: Enter Information: fill in 2 boxes that says…Box #1 says…I don’t know what coverage I have. Box #2 says…I don’t know.
  5. Step 2 of 4: Enter Your Drugs
  6. Step 3 of 4: Select Your Pharmacies…you can select only 2 pharmacies.
  7. Step 4 of 4 Redefine Your Plan…for prescription drug plan only check first box. For MAPD click what Medicare Advantage Plan best fits your Medicare Prescription Drug needs. You can check both or all 3 boxes if you like.
  8. Finally…Your Plan Results…click on the first boxes (maximum of 3). Chose the first box and then pick 2 more and make sure that you have chosen one with the Part D deductible and one which is enhanced with no deductible.
  9. View Your Plan Comparison…it will tell you the monthly premium, deductible, costs and if all drugs are covered on the plan you have picked.
  10. Under section saying, “Monthly Drug costs at Retail Pharmacy…your monthly costs and if or when you go into the donut hole or into catastrophic coverage will appear.
  11. Click on “View Drug Cost Summary” this section tells the pharmacy price for each prescription with also copay and cost when in coverage gap and catastrophic coverage.

Pick which Medicare Part D plan best fits your needs, covers your prescriptions and the pharmacy that you like is included.  For extra guidance in choosing which Medicare Part D or Medicare Advantage plan meets your needs call the new Toni Says Medicare call center at 1/844-250-8664 or enroll on your own via the website.

The new Medicare Survival Guide® Advanced is on sale at Confused about Medicare and TRS Medicare webinars are now available online at for those who could not attend a local workshop.

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