It's overwhelming (but that's the program). I was pleasantly surprised that I was able to find the information for our new circumstances (my spouse will be in the donut hole) as easily as I did. Some of what I found surprised me, and makes picking the best plan quite challenging - but the challenge isn't because of the site - it's because #%*! rules, which Congress needs to fix.
Things that surprised me:
Prices for most of our standard drugs are cheaper in the donut hole than before. It turns out that most of the Part D plans pass 50-80% of their negotiated price for the cheaper drugs on to us (so they pay only 20-50%). In the donut hole, the cap is 25%, so the price goes down for the drugs where there is a high pass through price.
Prices for some drugs increase after we emerge from the donut hole. Once you emerge from the donut hole, the price is 5% OR $4.15 - whichever is more. So drugs which cost below $4.15 in the donut hole will increase in price once you emerge.
Things I knew from last year:
Price your plan both through each plan (drug by drug) AND buying each drug without insurance through Costco or GoodRx. We buy more than half of our drugs outside of the Part D plan - it's no surprise, now that I'm looking at the passed on % (which the website provides) that a lot of them are cheaper if we just ignore insurance.
The negotiated prices between companies can vary as much as 40 x (e.g. one plan negotiated $2 for a drug - and another negotiated $80 for the exact same drug). (All of the negotiated prices are available in the website, so you can see exactly what you are paying - and what the insurance company is paying, and you can add up the total spend to figure out when you enter the donut hole.)
I created a big spreadsheet last year for the 24 plans available in my area - using the cheaper of buying the meds via Costco or using the plan price on a drug by drug basis. It saved me $120 (roughly 25%), and my spouse $310 (roughly 30%) over the cheapest plan for each of us.
Based on my spreadsheet this year - I'll be using the same plan. Even though I have significant acute medical conditions (I was shocked when I counted them up recently) they don't end up in long-term medications. So I'm a cheap date as far as drugs go. My spouse, on the other hand, is on lots of medications - and added a new medication this year, which will put her in the donut hole. The only question is when (sometime between April and July). So I have to do lots of different calculations - I'm in the process of building a new and improved spreadsheet which does the "inside the donut hole calculations" I was able to skip last year. It's a nightmare. But the site makes the data I need easy to gather.
If you've got questions about how the website works or how Part D works with a generic plan I can try to answer them for you . . . I've spent way more time than is healthy on the website.
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