Plans & Coverage
Part D Prescription Drug Plans
Medicare Part D covers prescription drugs. You can get it as a standalone plan (with Original Medicare or Medigap) or built into a Medicare Advantage plan. For 2027, the standard benefit has a $700 deductible and a $2,400 annual out-of-pocket threshold. Plan deductibles and cost-sharing can vary, so check each plan's details.
How to choose
A low premium does not necessarily mean lower total costs. Check whether your medications are on each plan’s formulary, their tiers, the deductible, and other cost sharing. We can help review estimated costs for plans we represent and are licensed to offer; verify current details with each plan.
The 2027 standard benefit
The former coverage-gap phase is gone. Under the 2027 standard benefit, the deductible is $700 and the annual out-of-pocket threshold is $2,400. After your qualifying out-of-pocket costs reach the threshold, you pay no cost-sharing for covered Part D drugs for the rest of the year. Plans may use different deductible and cost-sharing designs; review each plan's benefit details.
Questions, answered
What is the Part D late enrollment penalty?
After your Initial Enrollment Period ends, you may owe a Part D late enrollment penalty if you go 63 or more days in a row without Part D or other creditable prescription drug coverage. The penalty is generally 1% of the national base beneficiary premium for each full uncovered month and is added to your Part D premium for as long as you have drug coverage. You don't pay the penalty while receiving Extra Help. Keep coverage notices and confirm whether other coverage is creditable.
Can I change Part D plans every year?
Yes. During the Annual Enrollment Period (Oct 15–Dec 7), you can make certain plan changes for the next year. Review your Annual Notice of Change and compare available options against your current medications and needs; we can help review plans we represent.
What happens to covered drug costs after I reach the 2027 Part D out-of-pocket threshold?
After you reach the 2027 out-of-pocket threshold, you won’t pay out-of-pocket for covered Part D drugs for the rest of the calendar year. Plan premiums remain due, and plan designs can vary.
Does my Medicare Advantage plan include Part D?
Most Medicare Advantage plans include Part D drug coverage, but not all. Whether you can add a separate Part D plan depends on the type of Medicare health plan; joining one may end Medicare Advantage coverage for some plan types. Check with the plan before enrolling. We can help review formulary information for plans we represent; confirm current coverage with the plan.
What is a drug formulary and why does it matter?
A formulary is a plan’s list of covered drugs, organized into tiers that affect your costs. If a drug is not covered, you or your prescriber can ask the plan about an exception; approval is not guaranteed, and you may otherwise pay out of pocket. We can help review formulary information for plans we represent and are licensed to offer; confirm current coverage and costs with the plan.
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