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 2026, Part D includes an annual out-of-pocket cap of about $2,100 — once you reach it, covered drugs cost you $0 for the rest of the year.
How to choose
The cheapest premium is rarely the cheapest plan. What matters is whether your specific drugs are on the plan's formulary, what tier they're on, and the deductible. We run your prescription list against every plan to find your lowest total cost.
The 2026 $2,100 cap
The old 'donut hole' is gone. Once your out-of-pocket drug costs hit roughly $2,100 in 2026, you pay nothing more for covered drugs that year — major protection if you take expensive medications.
Questions, answered
What is the Part D late enrollment penalty?
If you go without creditable drug coverage after you're first eligible for Medicare, a permanent late enrollment penalty is added to your monthly premium. The penalty is 1% of the national base premium for every month you went without coverage. Enrolling on time — or keeping creditable employer drug coverage — avoids it.
Can I change Part D plans every year?
Yes. During the Annual Enrollment Period (Oct 15–Dec 7) you can switch Part D plans for the next year. We review your plan each fall to make sure your medications are covered at the best cost.
What is the 2026 Part D out-of-pocket cap?
For 2026, the Medicare Part D out-of-pocket cap is approximately $2,100. Once you reach this threshold, covered drugs cost you $0 for the rest of the year — a major change from the previous 'donut hole' system.
Does my Medicare Advantage plan include Part D?
Most Medicare Advantage plans (called MAPD plans) include Part D drug coverage. If your plan does not include drug coverage, you would need a standalone Part D plan. We verify formulary coverage for your specific medications before enrollment.
What is a drug formulary and why does it matter?
A formulary is the list of drugs a Part D plan covers, organized into tiers that determine your cost. If your medication is not on the formulary, you may pay full price. We check your full prescription list against every plan's formulary to find the lowest total cost — not just the lowest premium.
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