Prescription Drug Coverage (Part D)

Rows of prescription pill bottles lined up on pharmacy shelves.

The 2026 out of Pocket Cap for Part D will be $2,100

2 ways to get Part D Coverage

How do you know which Medicare Part D drug plan or Medicare Advantage Plan to enroll in? With our quoting tools, we will show you the bottom line, helping you find which plan covers your prescription drugs the best and minimizes your out-of-pocket costs.

-MAPD-Medicare Advantage Prescription Drug Plan

Most Medicare Advantage Plans include Medicare Part D coverage, but not all plans offer the same prescription drug benefits. Some Medicare Advantage Plans may provide better coverage for specific medications than others. For example, one plan might require $2,000 in annual prescription copays, while another could limit your out-of-pocket expenses to just $500. We simplify the process by showing you which carrier and plan provides the best coverage for your medications, helping you find the most cost-effective prescription drug plans and save money.

-PDP-Stand Alone Prescription Drug Plan (seperate to your supplement)

If you choose a Medicare Supplement Plan, you will also need a separate stand-alone Medicare Part D plan for your prescription coverage. How do you determine which Prescription Drug Plan is best for you? Just provide us with a list of the prescriptions you take, including dosage and frequency, and we'll help you identify the optimal drug plan available in your zip code based on your specific prescription needs.

Annual Policy Review

It's important to review your Medicare Part D drug coverage each year during the Annual Election Period, which runs from October 15th to December 7th. Reviewing your coverage annually is essential because you could be taking new medication that hasn't been accounted for, your Medicare Advantage Plans may change, affecting how your current medications are covered the following year, and there might be changes in legislation or CMS regulations.

Medicare Part D Premium-IRMAA

Since Medicare Part D plans are offered by private insurance carriers, there is no one standard premium. Instead, the premium will depend on the specific carrier and coverage options of the plan. Most Medicare Advantage Plans also include prescription drug coverage, meaning individuals enrolled in those plans will not have a separate premium for Medicare Part D.

The total cost for Medicare Part D will depend on several factors:

- The plan’s specific premium and deductible

- Whether the prescription drug coverage is through a stand-alone Medicare Part D plan or as part of a Medicare Advantage Drug Plan (MAPD)

- If the individual receives financial assistance from the Extra Help program

- The medications each individual takes and how often they are refilled

- The pharmacy used

- If the medication is covered under the plan’s drug formulary

-Ask to determine which IRMAA bracket you fall into.

The five prescription drug tiers include:

- Preferred generics

- Generics

- Preferred brands

- Non-preferred drugs

- Specialty drugs

Make Late Medicare Part D Premium Payments

Medicare has its own rules regarding late and missed payments, but it ultimately depends on an individual’s plan on how to proceed with late payments. According to the regulations set by the Medicare program, if an individual is late in paying a premium, they can still receive coverage without a penalty. They are also granted a grace period along with warnings and notifications about the late or missed payments. Medicare will send the beneficiary a letter by mail instructing them to contact their plan’s carrier regarding the payment.

Regardless of the carrier, individuals must be notified before being dropped from the plan. Grace periods must be allowed for a minimum of two months, although some plans may offer an extended grace period. This grace period will begin on the first day after the payment is due.

Part D Disenrollment

Plans with a Single Grace Period may disenroll individuals who miss one or more premium payments during that grace period. The individual will be dropped from coverage at the end of the allotted timeframe.

Plans that have a Rollover Grace Period allow their members to stay enrolled if they owe more than one month’s premium but pay at least one premium during the grace period. If this occurs, a new grace period will commence. However, if no payment is made, the carrier may disenroll the individual from the plan.

Insurance companies will send notifications to members who have failed to pay their premiums but will disenroll any member who does not make a payment during the grace period.

Once an individual has been disenrolled from a plan, they will need to submit an application for coverage.