Consider costs, coverage, and restrictions when shopping for a Medicare Part D plan.

Coverage under the new Medicare Part D prescription drug program is not handled by Medicare itself. Instead, it is managed by private health insurers and managed health care companies, which offer different plans in different geographic areas. If and when you decide to enroll in Part D, you need to find out which private drug plans are available in your area and then select the best plan for your needs.

If you need basic information about Part D before you select a plan, check out the new edition of Nolo's Social Security, Medicare & Government Pensions, which contains more detailed information on Medicare Part D.

Read on even if you're automatically enrolled. If you qualify for Medicaid, you will be automatically enrolled in a Part D plan. However, you may switch plans if you find one better suited to your needs.

Finding Available Part D Plans

You may enroll only in a plan that operates in your geographic area. The following organizations can give you information about the Part D plans available to you.

Medicare. The Centers for Medicare and Medicaid Services (CMS) can tell you what plans are available where you live and can help narrow your options based on the medicines you regularly take. Contact CMS by phone at 800-MEDICARE (800-633-4227) or online at www.medicare.gov.

SHIP or HICAP. The State Health Insurance Assistance Program (SHIP), sometimes called the Health Insurance Counseling and Advocacy Program (HICAP), can tell you about the Part D plans available where you live, which ones cover the drugs you regularly use, and how much the plans cost. For the nearest SHIP or HICAP office, check the business listings of your white pages phone directory.

State department of insurance. Every state has a government agency that oversees insurance matters. You can contact your state department of insurance for the names, addresses, and phone numbers of all companies that offer a Part D plan in your state.

The best information comes from the plan itself. Before you make a final choice, directly contact any plan that interests you and ask for a complete description of the plan, the drugs it covers, and its costs. You can get the phone number and address of any plan from Medicare or your state department of insurance.

Your prescriptions. The prescription medications you regularly take, or their generic equivalents, must be included on the plan's formulary (its list of covered drugs). If not, the plan is useless to you. If you cannot find a plan that includes all of your drugs, look for one that covers your most expensive drugs.

Costs. The costs of a Part D plan can vary in several ways. Premium payments often vary, but the copayment amounts are more important. Most plans have tiered copayments, meaning the copayments differ for generic versus brand-name drugs and for different classes of medications. Compare the copayment amount under each Part D plan you're considering for each drug you take.

Coverage gap. Determine whether the plan provides any benefits within the so-called coverage gap. Part D plans are allowed to provide no coverage after you and the plan have spent a certain amount -- $2,250 in 2006 -- on medications and until you have paid an additional amount out of your own pocket -- $2,850 in 2006.

Access restrictions. You must determine whether a plan places any access restrictions on your drugs, such as prior authorization, generic drug or equivalent drug substitution, step therapy, or supply limits. The fewer restrictions a plan has regarding your drugs, the better for you.