Part D plans are offered by private insurers and cover outpatient prescription drugs. Each plan has its own formulary (drug list), pricing tiers, preferred pharmacies and rules like prior authorization or quantity limits.
The lowest premium is rarely the lowest total cost. A plan with a $0 premium can cost hundreds more per year if one of your medications sits on a higher tier. We run a full-year cost estimate for your list at your pharmacy, whether that is a Fry's, Walgreens, Costco or mail order.
Since 2025 there is a yearly cap on out-of-pocket drug costs for covered Part D drugs, and you can spread costs across the year with the Medicare Prescription Payment Plan. If you do not sign up when first eligible and lack other creditable drug coverage, a late enrollment penalty is added to your premium for life.
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What is included
The coverage you can expect. Exact benefits depend on the plan and the insurance company you choose.
Generic and brand drugs
Medications on the plan formulary, grouped into cost tiers.
Insulin savings
Covered insulins cost no more than $35 for a month's supply.
Recommended vaccines
Adult vaccines like shingles and Tdap at no cost to you.
Mail-order pharmacy
90-day supplies delivered to your door, often at lower cost.
Payment plan option
Spread drug costs into monthly payments through the Medicare Prescription Payment Plan.
Coverage reviews
Exceptions and appeals when a drug you need is not on the formulary.
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How we help you choose
Build your drug list
Name, dose and how often. Photos of your bottles work fine.
Run the numbers
We compare total yearly cost, not just premiums, at the pharmacies you actually use.
Re-check every fall
We review your plan during each Annual Enrollment Period so changes never catch you off guard.
Why people choose it
Yearly out-of-pocket cap on covered drugs
Protection from the lifetime late enrollment penalty
Lower costs at preferred pharmacies
Annual review included at no cost
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Costs, and what moves them
Sample figures to help you plan. Your advisor confirms the exact amounts for your age, ZIP code and plan.
Sample costs for Part D drug plans. Illustrative only, not a quote.
Cost
Sample amount
Good to know
Monthly premium
$0 - $98
Sample range in Pima County
Yearly deductible
$0 - $615
Maximum set by Medicare (2026 sample)
Out-of-pocket cap
$2,100 / year
Covered Part D drugs (2026)
Covered insulin
Up to $35 / month
Per month's supply
Factors that change your price
Which tier each of your drugs falls on
Preferred versus standard pharmacy pricing
Your income, which may add an IRMAA surcharge
Whether you qualify for Extra Help
Figures are illustrative samples and not a quote. Medicare amounts change every January.
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Part D drug plans questions we hear
Usually yes. If you go 63 days or more without creditable drug coverage after your enrollment period, a penalty is added for as long as you have Part D. A low-premium plan protects you.
You can ask your doctor about a covered alternative, request a formulary exception, or switch plans during the next enrollment period. We help with all three.
Plans can make limited mid-year changes, such as replacing a brand drug with a new generic. Big changes happen on January 1, which is why we review every fall.
Yes. Extra Help (the Low-Income Subsidy) lowers premiums and copays for people with limited income and resources. Our prescription drug help page explains how to apply.
