Medicare Part D
Prescription drug coverage that helps lower the cost of your medications. Find a Part D plan that covers the drugs you need at a price you can afford.
What is Medicare Part D?
Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps cover the cost of prescription drugs, including many recommended shots and vaccines.
Part D plans are available as standalone Prescription Drug Plans (PDPs) that work alongside Original Medicare and Medigap, or as part of a Medicare Advantage plan that includes drug coverage (MA-PD).
Each plan has its own list of covered drugs (formulary), network pharmacies, and costs. It's critical to review plans annually because formularies and pricing change each year — even if you're happy with your current plan.
How Part D Coverage Works
Deductible Phase
You pay the full cost of your drugs until you meet the annual deductible (some plans have $0 deductibles for certain drugs).
Initial Coverage
After the deductible, you pay a copay or coinsurance for each drug. The plan pays the rest until you reach the coverage limit.
Coverage Gap
Thanks to recent legislation, the coverage gap (donut hole) has been largely eliminated for brand-name and generic drugs.
Catastrophic Coverage
After reaching the out-of-pocket threshold, you pay little to nothing for covered drugs for the rest of the year.
Tips for Choosing a Part D Plan
- Make a list of all your current prescriptions, including dosage and quantity
- Check that your preferred pharmacy is in the plan's network
- Compare total annual cost — not just the monthly premium
- Look at the plan's formulary to ensure your drugs are covered
- Review plans every year during the Annual Enrollment Period (Oct 15 – Dec 7)
- Ask about Extra Help — a federal program that helps pay Part D costs for eligible individuals
Frequently Asked Questions
What is Medicare Part D?
Medicare Part D is the prescription drug benefit program. It is offered through private insurance companies approved by Medicare. Part D helps cover the cost of prescription medications, including brand-name and generic drugs. You can get Part D through a standalone plan (PDP) or as part of a Medicare Advantage plan that includes drug coverage.
When can I enroll in a Part D plan?
You can enroll during your Initial Enrollment Period (when you first become eligible for Medicare), the Annual Enrollment Period (October 15 – December 7), or a Special Enrollment Period if you qualify. If you delay enrollment without creditable drug coverage, you may pay a permanent late enrollment penalty added to your monthly premium.
What is the Part D late enrollment penalty?
If you go 63 or more consecutive days without creditable prescription drug coverage, you may owe a late enrollment penalty when you eventually sign up. The penalty is calculated as 1% of the national base beneficiary premium multiplied by the number of months you went without coverage, added to your monthly premium for as long as you have Part D.
What is the Part D donut hole?
The donut hole (coverage gap) was a phase where you paid more for prescriptions after your total drug costs reached a certain amount. As of 2025, the Inflation Reduction Act has effectively eliminated the donut hole by capping annual out-of-pocket drug costs at $2,000. Once you reach that limit, you pay nothing for the rest of the year.
How do I choose the right Part D plan?
Start by listing all your current medications with dosages. Then compare plans based on whether your drugs are on the plan's formulary (covered drug list), what tier each drug falls on, which pharmacies are in-network, and the total estimated annual cost including premiums, deductibles, and copays. An insurance agent can run this comparison for you at no cost.
Let Us Review Your Drug Coverage
Bring us your medication list and we'll compare Part D plans to find the one that saves you the most — at no cost to you.