Medicare Prescription Drug Plans
The right Medicare prescription drug plan depends on more than the monthly premium. We can help you compare plans based on your medications, preferred pharmacies, coverage, and potential costs.
Because formularies, pharmacy networks, and prescription costs can differ between plans, a plan that works well for one person may not be the best fit for someone else.
Plan availability, formularies, pharmacy networks, costs, and coverage requirements vary by plan and service area.
Finding the Right Part D Plan Starts With Your Prescriptions
There isn't one Medicare drug plan that's best for everyone. The medications you take, where you fill your prescriptions, and how each plan covers those drugs can make a significant difference in your overall costs.
Start With Your Medication List
Make a current list of the prescriptions you take, including the drug name, dosage, and how often you take it. This gives you a much more accurate starting point for comparing plans.
Check Each Plan's Drug List
Medicare drug plans have formularies, or lists of covered medications. The same prescription may be covered differently from one plan to another, including which drug tier it is placed on.
Compare Your Pharmacies
What you pay can depend on where you fill your prescriptions. Plans may have preferred and standard network pharmacies, so your usual pharmacy may not provide the lowest cost under every plan.
Look at the Total Cost
Compare the monthly premium together with the deductible and what you may pay for your prescriptions. A lower-premium plan isn't necessarily the plan that will cost you less overall.
The Cheapest Premium Isn't Always the Cheapest Plan
A plan can have a low monthly premium and still cost you more depending on how it covers your prescriptions and which pharmacy you use. The better comparison is the estimated overall cost of your coverage based on the medications you actually take.
Have your medication list ready? We can help you compare your options.
Compare My Drug Plan OptionsWhat Does Medicare Part D Cover?
Medicare Part D helps cover the cost of prescription medications. You can get Part D coverage through a standalone Medicare Prescription Drug Plan or through many Medicare Advantage plans that include prescription drug coverage.
Part D Plans Cover a Range of Prescription Drugs
Each plan has a formulary, or list of medications covered by the plan.
Covered medications are typically placed into different cost-sharing tiers.
Medicare requires Part D formularies to meet certain coverage requirements.
Some medications may have coverage rules such as prior authorization, step therapy, or quantity limits.
Covered Doesn't Always Mean Covered the Same Way
Two Part D plans may both cover the same medication but place it on different tiers, use different pharmacy networks, or have different coverage requirements. That's why checking your actual prescriptions is more useful than simply comparing a list of plans.
What Can Make One Drug Plan Better Than Another?
Medicare drug plans don't all cover prescriptions the same way. Small differences in a formulary, drug tier, pharmacy network, or coverage rule can change which plan makes the most sense for you.
The Formulary
Each plan maintains its own list of covered prescription drugs. Before enrolling, check whether the medications you currently take are included on the plan's formulary.
Drug Tiers
Plans organize covered medications into tiers that can affect what you pay. The same medication isn't necessarily placed on the same tier by every plan.
Pharmacy Networks
A pharmacy that's convenient for you may not offer the same plan pricing as another network pharmacy. Some plans distinguish between preferred and standard network pharmacies.
Deductibles & Cost Sharing
Look at more than the monthly premium. A plan's deductible and the amount you pay when filling prescriptions are also important pieces of the overall cost.
Coverage Requirements
Certain medications may require prior authorization, step therapy, or have quantity limits. These rules can differ between plans even when the medication itself is covered.
Your Prescriptions Can Change
The plan that fits your medication list today may not always remain the best fit. Reviewing your coverage periodically is especially important when your prescriptions or plan details change.
Two Plans Can Look Similar — Until You Add Your Prescriptions
Imagine two available Part D plans with similar premiums. Looking only at the monthly price might make them appear nearly interchangeable. Once your medications and pharmacy are included, the comparison can look very different.
Compare the Plan Around You — Not the Other Way Around
Your prescriptions and preferred pharmacies should drive the comparison. That's more useful than choosing a plan because someone you know likes it or because its premium caught your attention.
When Can You Enroll in or Change a Medicare Drug Plan?
Medicare has specific enrollment periods for joining or changing prescription drug coverage. The right enrollment period depends on your individual situation.
New to Medicare
When you first become eligible for Medicare, you generally have an Initial Enrollment Period when you can choose prescription drug coverage. See our Turning 65 Medicare Guide for more information about getting started with Medicare.
Annual Enrollment Period
Medicare's Annual Enrollment Period runs from October 15 through December 7 each year. During this period, you can review your coverage and make certain changes for the following year.
Special Enrollment Situations
Certain life events or changes in your coverage may give you an opportunity to enroll or make changes outside the standard enrollment periods. The rules and timing depend on the qualifying situation.
Don't Wait Until You Need a Prescription to Think About Part D
Going without creditable prescription drug coverage when you're eligible for Medicare can potentially result in a Part D late enrollment penalty if you enroll later. If you have drug coverage through an employer, union, or another source, find out whether that coverage is considered creditable before making a change.
Prescription Drug Plan FAQs
Answers to common questions about Medicare Part D coverage, prescription costs, enrollment, and comparing plans.
If you have Original Medicare and don't have other creditable prescription drug coverage, you may want to consider a standalone Medicare Part D plan. Many Medicare Advantage Plans already include prescription drug coverage, so you generally wouldn't add a separate Part D plan to those plans.
Each Medicare drug plan has a formulary, which is its list of covered medications. When comparing plans, check your specific prescriptions, dosage, and frequency rather than assuming that every Part D plan covers your medications in the same way.
Plans can place medications on different formulary tiers, use different pharmacy networks, and apply different cost sharing or coverage requirements. That's why comparing your actual medications and preferred pharmacies is more useful than choosing a plan based only on its monthly premium.
It can. Medicare drug plans have pharmacy networks, and some plans may offer different cost sharing at preferred versus standard network pharmacies. Before choosing a plan, check how it works with the pharmacies you prefer to use.
Medicare's Annual Enrollment Period runs from October 15 through December 7 each year and allows Medicare beneficiaries to make certain coverage changes for the following year. Some people may also qualify for a Special Enrollment Period based on their circumstances.
You may owe a Part D late enrollment penalty if, after becoming eligible for Medicare, you go 63 days or more without Part D or other creditable prescription drug coverage and later enroll. If you're approaching Medicare eligibility, our Turning 65 Medicare Guide explains more about getting started with Medicare.
If you qualify for both Medicare and Medicaid, your prescription coverage and enrollment options may work differently. Depending on your eligibility and location, you may also have access to a Dual Special Needs Plan (D-SNP) that includes Medicare prescription drug coverage.
Need Help Comparing Medicare Drug Plans?
Have your medication list ready and we'll help you review your options.
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