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The Six-Step Pathway
Work through these in order. Each step changes the results of the one after it.
1
Go to Medicare.gov/Plan-Compare
Start at the official Plan Finder. It is the only tool with real-time plan data for your area, and it is free to use.
2
Enter Your ZIP Code and Drugs
Add every medication with the exact dosage and monthly quantity. One missing drug can change the ranking completely.
3
Select Your Pharmacy
Pick the pharmacies you actually use, including mail order. Preferred versus standard pharmacy status changes what you pay.
Compare Total Annual Drug Costs
Sort by estimated total yearly cost, not by premium. The lowest premium plan is frequently not the cheapest overall.
5
Check Drug Tiers and Copays
Open each plan's formulary detail and look for tier placement, prior authorization, step therapy, and quantity limits.
6
Enroll During Your IEP or AEP
Enroll through Medicare.gov or directly with the plan inside your enrollment window. Save your confirmation number.
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Standalone Part D Prompts
Copy any prompt, fill in the bracketed details inside your own AI tool, and verify the result against the Plan Finder.
Audit My Drug List Against a Part D Formulary
Turns your medication list into concrete formulary questions to verify.
Here are my medications with dosage and monthly quantity: [list]. I live in [ZIP code] and use [pharmacy name].
Explain how Part D formularies work: tiers, prior authorization, step therapy, and quantity limits. For each of my drugs, tell me what to look for in a formulary and what a lower-cost alternative conversation with my prescriber
Open an AI tool
Do I Owe a Part D Late Enrollment Penalty?
Explains creditable coverage and how the penalty is calculated and appealed.
My coverage history since turning 65: [describe each period, including employer, VA, TRICARE, or no coverage]. I am now enrolling in Part D on [date].
Explain the Part D late enrollment penalty: what creditable coverage means, how uncovered months are counted, how
Open an AI tool
Compare Pharmacy Options for My Prescriptions
Preferred pharmacies, mail order, and 90-day fills side by side.
My medications are: [list]. I currently fill at [pharmacy] in [ZIP code]. I [do / do not] want mail order.
Explain how preferred versus standard network pharmacies change my copays, when 90-day fills save money and when they do not, and how mail order works for
Open an AI tool
Request a Part D Coverage Determination or Exception
Drafts the exception request when a needed drug is not covered.
My Part D plan [does not cover / requires prior authorization for / limits the quantity of] this medication: [drug, dosage, quantity]. My prescriber's reasoning is: [describe].
Explain the Part D coverage determination and exception
Open an AI tool
Re-Check My Drug Plan Before the Deadline
A yearly re-shopping routine so formulary changes never catch you out.
My current Part D or Advantage drug coverage is [plan name]. My Annual Notice of Change says: [paste changes]. My current medications: [list].
Build my annual re-check routine: what changed in my formulary and cost sharing, how to estimate next year's total drug cost, and which of my drugs are
Open an AI tool