Avoid restrictions. Some part D plans require prior authorization before you can fill certain prescriptions and have quantity limits regarding how much medication you can get at one time. You could also be required to try one or more similar, lower-cost drugs before the plan will cover a more expensive prescribed drug. "It's also important to check whether the plan you're considering has any restrictions on your drugs, like prior authorization or step therapy. Those can be a real hassle," says Elizabeth Hargrave, a senior research scientist at NORC at the University of Chicago. "If there's a specific drug that you really need, it's worth looking into how much of a hassle it would be to actually get it."
Mind your gap coverage. Seniors who reach the donut hole gap in prescription drug coverage in 2013 will get 52.5 percent off the cost of brand-name drugs and 21 percent off the cost of generic drugs, up from 50 percent and 14 percent, respectively, in 2012. Some plans offer additional gap coverage for an extra cost. "If people know in advance that they use a lot of drugs and are likely to have enough spending to reach the coverage gap, it might be worth the extra premiums to have the gap coverage," says Cubanski. But she cautions, "Some of the plans that offer additional gap coverage are very expensive, but they don't actually offer all that much coverage beyond what people are already entitled to due to the health reform law."