Check your medications
Each plan has a list of covered drugs, called a formulary. Confirm that your prescriptions are included and understand their costs.
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Prescription coverage that makes sense.
Part D is Medicare’s prescription drug coverage. The right fit depends on your medications, pharmacy, and budget.
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Know your options. Make your choice with confidence.
Part D plans are offered by private insurance companies approved by Medicare. Plan details can vary, so it’s worth looking beyond just the monthly premium.
Compare pharmacies
Your preferred pharmacy and the plan’s pharmacy network can affect what you pay.
Look at total costs
Consider premiums, deductibles, copayments, and coinsurance together when reviewing a plan.
Review coverage each year
Plans and drug lists may change. An annual review helps you see whether your coverage still fits.
A closer look
The details worth understanding
How drug coverage is offered
You can generally get Part D through a standalone prescription drug plan alongside Original Medicare, or through a Medicare Advantage plan that includes drug coverage. Private insurers offer these plans under Medicare rules, and options vary by location.
Start with your medication list
Each plan has a formulary, or list of covered drugs, organized into tiers. The tier and any utilization rules—such as prior authorization, step therapy, or quantity limits—can affect access and cost. Check the exact drug, dosage, and quantity.
The pharmacy makes a difference
Plans have pharmacy networks, and some designate preferred pharmacies with lower cost sharing. Mail-order options can also vary. Compare prices using the pharmacy you actually want to use, not only the plan’s advertised premium.
Compare total yearly costs
Add the monthly premium, any deductible, and your expected copays or coinsurance for your prescriptions. The least expensive premium is not always the lowest-cost plan overall. Part D has an annual out-of-pocket cap for covered drugs, which can change by year.
Enrollment timing matters
You can usually join during your Initial Enrollment Period or change plans during Medicare Open Enrollment, October 15 through December 7, for coverage starting January 1. Certain life changes may qualify you for a Special Enrollment Period.
Review your plan every fall
Formularies, pharmacy networks, and prices can change each year. Read your Annual Notice of Change and rerun the comparison using your current medications and pharmacies before the next plan year begins.
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Common questions
Good questions deserve clear answers.
Every situation is different. These answers are a starting point, and we’re happy to talk through yours.
Is Part D required?
Part D is optional, but going without Part D or other creditable prescription coverage after you become eligible may result in a late enrollment penalty if you enroll later.
Can I have Part D with a Medicare Supplement?
Yes. If you have Original Medicare and a Medigap policy, you can generally enroll in a standalone Part D plan. Modern Medigap policies do not include prescription coverage.
What if my medicine is not on a plan’s list?
Ask your prescriber about an alternative covered drug, or ask the plan about a formulary exception. An exception is not guaranteed; review the plan’s rules before joining.
Can I change plans every year?
Generally, yes. Medicare Open Enrollment runs October 15 through December 7 each year, and changes usually begin January 1. Other enrollment periods may be available when you have a qualifying life event.
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We’ll listen to your questions and help you decide what to look at next, at your pace.