Medicare Part D – Prescription Drug Plans
Medicare Part D provides prescription drug coverage through private insurance companies. In 2026, out-of-pocket drug costs are capped at $2,100 — a major improvement for beneficiaries.
Medicare Part D – Prescription Drug Plans
Medicare Part D helps pay for prescription drugs. Coverage is offered by private insurance companies approved by Medicare, either as a standalone Prescription Drug Plan (PDP) or as part of many Medicare Advantage plans.
How Part D Works
Each Part D plan has its own:
- Formulary — the prescription drugs the plan covers
- Drug tiers — which determine copays or coinsurance
- Pharmacy network — including preferred pharmacies that may offer lower costs
- Premium and deductible
- Cost for your specific medications
The lowest-premium plan is not always the lowest-cost plan. Your prescriptions and pharmacy should be reviewed before selecting a plan.
2026 Part D Costs
Starting 2025, Part D has only 3 stages (no more coverage gap):
- 1Yearly Deductible (up to $615; some plans have $0)
- 2Initial Coverage (standard benefit is 25% coinsurance; most plans use tiered copays that achieve equivalent value)
- 3Catastrophic Coverage (plan pays 60%, drug manufacturers 20%, Medicare 20%)
2026
Out-of-Pocket Cap (2026)
$2,100
Once you hit this, you pay $0 for covered drugs for the rest of the year
Max Deductible (2026)
$615
Some plans have $0 deductible
After $2,100 cap
$0
You pay nothing for covered Part D drugs for the rest of the calendar year
2027
Out-of-Pocket Cap (2027)
$2,400
Once you hit this, you pay $0 for covered drugs for the rest of the year
Max Deductible (2027)
$700
Some plans have $0 deductible
After $2,400 cap
$0
You pay nothing for covered Part D drugs for the rest of the calendar year
Late Enrollment Penalty
If you go 63 days or more without Part D or other creditable prescription drug coverage after becoming eligible, you may owe a Part D late enrollment penalty.
The penalty is 1% of the national base beneficiary premium (NBBP) multiplied by the number of months you went without coverage, rounded to the nearest $0.10. In 2026, the NBBP is $38.99/month.
Example — 24 months without coverage:
$38.99 × 0.24 = $9.36 → rounded to $9.40/month added to your Part D premium
The penalty is added to your Part D premium every month for as long as you have Part D. The dollar amount recalculates each year because the NBBP changes annually.
Comparing Part D Plans
I can help you review the standalone Part D plans available in your area, including plans I do not represent or cannot enroll you in directly.
A Part D comparison should consider your:
- Prescription drugs and dosages
- Preferred pharmacy
- Plan formulary
- Drug copays and coinsurance
- Deductible
- Monthly premium
- Estimated total annual cost
There is no additional charge for my assistance comparing your options.
Schedule an AppointmentPrefer to Compare Plans Yourself?
Medicare.gov provides the complete Medicare Plan Compare tool. You can enter your prescriptions and pharmacy and compare the Medicare Part D plans available in your area.
Compare All Plans at Medicare.govEnrolling in a Part D Plan
For some standalone Part D plans, I can help you evaluate the plan, but you may need to complete the enrollment yourself.
If you have already reviewed your options and know which carrier and plan you want, the personalized carrier links below allow you to complete your enrollment directly with the insurance company.
Carrier Self-Enrollment
These carrier links are provided for beneficiaries who have already decided which carrier and plan they want. They are not a complete list of Part D plans available in your area.
If your preferred carrier is not listed above, you can enroll through Medicare.gov Plan Compare or contact the insurance company directly.
Not Sure Which Plan to Choose?
Do not select a Part D plan based only on the premium.
Contact me first. I can review your medications, pharmacy, and available plans with you before you enroll.
Medicare GLP-1 Bridge Program
Eligible Part D beneficiaries may access Wegovy, Zepbound KwikPen, and Foundayo for a $50 monthly copay — separate from your regular Part D benefit.
Review Your Part D Plan Every Year
Part D premiums, formularies, pharmacy networks, and prescription costs can change each year.
The Medicare Annual Enrollment Period is:
October 15 – December 7
This is your opportunity to review your current coverage and, when appropriate, change Part D plans for January 1 of the following year.
Last reviewed: August 2026. Medicare plan availability, costs, formularies, and enrollment options can change. Verify current information at Medicare.gov.