Medicare Prescription Drug Plans (Part D)

How Part D Works

Medicare Part D is prescription drug coverage offered by private insurers. You can get Part D two ways:

• Standalone Part D plan — paired with Original Medicare or a Medicare Supplement
• Built into a Medicare Advantage plan — called a Medicare Advantage Prescription Drug (MAPD) plan

Why Plan Choice Matters So Much

Each Part D plan has its own formulary — the list of drugs it covers and how much they cost. The same medication can cost $4 on one plan and $140 on another. The right plan for you depends entirely on which specific drugs you take.

That’s why we always start by reviewing your medications before recommending anything. There’s no “best” Part D plan in general — only the best one for your specific drug list.

2026 Part D Changes

$2,000 Out-of-Pocket Cap

The most important recent change: there’s now an annual cap on what you pay out-of-pocket for prescription drugs covered by Part D. Once you hit it, your covered drugs are $0 for the rest of the year. For people on expensive medications, this is a major change.

$35 Insulin Cap

Insulin costs covered by Medicare are capped at $35 per month per prescription. No deductible applies to insulin.

Medicare Prescription Payment Plan

You can choose to spread your annual prescription costs across monthly payments instead of paying a large bill at the pharmacy counter. Helpful if you have a high-cost specialty drug.

Pharmacies Matter Too

Part D plans have preferred pharmacies that offer the lowest copays, and standard pharmacies that cost more. Many plans also have lower-cost mail-order options for maintenance medications. Where you fill matters as much as which plan you pick.

Extra Help / Low Income Subsidy

If your income is below certain thresholds, you may qualify for Extra Help — a federal program that drastically lowers your Part D costs. Many people who qualify don’t know it. We can help you check.