Medicare Part D Advisory Program Guide

Last updated October 2024

OnlyHealthInsurance does not represent, sell, or market Medicare Part D drug plans and receives no compensation from carriers. We provide resources and guidance for do-it-yourselfers and a consulting service for those who would like our plan evaluation and recommendation.

Thank you for the opportunity to help you with your Medicare Part D Prescription Drug plan decision for 2025. We have been helping clients with Medicare Part D since its inception in 2006. Using Medicare’s Plan Finder tool on the Medicare website, as well as non-government Part D resources, we will apply our knowledge to narrow down the selection (there are 18 qualified plans in 2025) and make our plan recommendation.

Let me share with you how we come to our recommendations. This is a list of the factors we consider before making our recommendation:

1). Are currently used drugs included in the plan
2). Cost factors (deductible, premium, drug copays and cost sharing).
3). Drug Plan Restrictions (Quantity Limits, Prior Authorizations and Step Therapy)
4). Plan Ratings (plan responsiveness, efficiency, quality and other functions measured by CMS)
5). Drug Formulary size
6). Plan reputation & experience in Part D
7). Preferred Pharmacy (Plans align with pharmacy chains to offer deeper discounts when utilized)
8). Personal Preferences (goals, requests and intentions)

Since all plans are structured using the same standardized benefit levels within an annual cycle, the results from the Plan Finder tool are a ranking based on how well plans perform through these levels from the medications entered.

This is the revised standard framework that all Part D drug plans must adhere to in 2025.

*The Standard Benchmark in the Initial Coverage level is a 25% co-insurance that the member pays for generic and brand name medications. In replace of this, plans may choose flat copays or lower co-insurance amounts and may vary based on the Tier level of the medication.

Final Note: Our analysis and recommendation is based primarily on information obtained from the Medicare Plan Finder, the resource tool recommended for use by the US government.  If it is determined that the information provided by the Plan Finder was incorrect or incomplete you may have no recourse to change plans and we will not be able assist you. This comparison has calculated the estimated costs based on drug costs on the day the evaluation was prepared.  Drug costs may change during the year.