Medicare Part D prescription plans

Part D is Medicare's prescription drug coverage, offered exclusively through private insurance carriers. If you have Original Medicare and a Medigap plan, you'll need a standalone Part D plan to cover your medications. The right plan depends entirely on the specific drugs you take, the pharmacy you use, and your county.

Find my best Part D plan →See Medicare basics →

Coverage guide

What this page is about

Medicare Part D is prescription drug coverage. This page is only about drug plans — formularies, tiers, deductibles, preferred pharmacies, penalties, and why the cheapest premium is often not the cheapest total cost.

Standalone Part D vs. drug coverage inside Advantage

If you have Original Medicare with a Supplement, you usually buy a standalone Part D plan. If you have Medicare Advantage, drug coverage is often included in the Advantage plan and must be checked as part of that plan comparison.

Drug tiers and pharmacy contracts change every year.
One plan can be excellent for one medication list and poor for another.
Skipping creditable drug coverage can create a lifetime late-enrollment penalty.

What it usually covers

Retail and mail-order prescriptions listed on the plan formulary
Generic, preferred brand, non-preferred brand, specialty, and selected vaccines
Negotiated pharmacy pricing and catastrophic coverage rules
Insulin and many common chronic-condition medications subject to plan terms

What it usually does not cover

Every medication automatically — non-formulary drugs may need exception requests
Over-the-counter medications unless specifically included by another benefit
The same cost at every pharmacy
Medical drugs billed under Part B, such as certain infusions or injections

Best fit

Anyone on Original Medicare who does not have other creditable drug coverage
People who take prescriptions and want the lowest total annual drug cost
Members who review medications every Annual Enrollment Period
Clients who use preferred pharmacies or mail-order strategically

Usually not the right fit

People already enrolled in an Advantage plan that includes drug coverage
Someone with employer or VA drug coverage that is better left untouched without review
Anyone choosing by premium only without checking total annual cost
People assuming last year's plan is still best after formularies changed

I compare Part D using your exact prescriptions, dosage, pharmacy, and refill pattern — not generic plan rankings.

Find my best Part D plan →See Medicare basics →

How it works

1Pick a plan tuned to YOUR drugs. Every plan has its own formulary, tiers, and preferred pharmacies. The right plan is the one that covers your list at the lowest total cost.
2Pay the plan premium. Standalone Part D premiums typically range $0–$80/month. High-income beneficiaries also pay a Part D IRMAA surcharge.
3Move through the phases. Deductible → Initial Coverage → 2025 introduces a $2,000 annual out-of-pocket cap; the old donut hole is eliminated.
4Re-shop every AEP. Formularies and pricing change every year. What was best in 2024 is rarely best in 2025 — I re-run your list every fall.

How Part D works

Every Part D plan has three main components you pay: a monthly premium, an annual deductible (up to $590 in 2025), and copays or coinsurance at the pharmacy counter. In 2025 a new $2,000 annual out-of-pocket cap goes into effect — once you hit it, covered drugs are $0 for the rest of the year.

Monthly premium ranges from ~$0 to $100+ depending on plan and county
Annual deductible (up to $590 in 2025) — some plans waive it on Tier 1 & 2 drugs
Copay tiers: Tier 1 preferred generic → Tier 5 specialty
New in 2025: $2,000 annual out-of-pocket cap on covered drugs
Preferred pharmacies get lower copays than standard pharmacies within the same plan

Why the 'cheapest premium' plan usually isn't cheapest

Every Part D plan has its own formulary (drug list), tier structure, and pharmacy network. A $0 premium plan can cost you $300/month at the counter for the exact medication a $40 premium plan covers as a Tier 1 generic for $3. We compare true annual cost — premium + deductible + copays — not just the sticker premium.

We run your exact medications through every plan in your county
Sort by true annual cost, not premium
Factor in your preferred pharmacy (Walmart, Publix, Kroger, CVS, mail order)
Recheck every fall — formularies, copays, and pharmacy networks change every year

Who needs Part D

You need Part D if you have Original Medicare (with or without Medigap) and don't have other creditable prescription coverage. If you're on a Medicare Advantage plan that includes drug coverage (most do), you already have Part D built in.

Original Medicare + Medigap → yes, add a standalone Part D
Medicare Advantage with drug coverage (MAPD) → no, drugs are included
Still on employer or union coverage that's certified 'creditable' → no, keep what you have
VA prescription benefits → no penalty for skipping Part D

The late-enrollment penalty is permanent

If you go 63+ consecutive days without Part D or other creditable drug coverage after you're first eligible, Medicare adds 1% of the national base premium (~$36.78 in 2025) to your Part D bill for every full month you were uncovered — for the rest of your life. Even if you take zero medications today, the cheapest compliant plan protects you from this permanent charge.

What we do for you

We use Medicare's official plan finder plus our own tools to compare every plan available in your county against your actual drug list. We factor in your pharmacy preference, whether you use mail order, and any drug substitutions your doctor is open to. Then we re-run the analysis every October when new plans are released — because the plan that was best this year is often not best next year.

2025 Part D — what changed

Rule	2024	2025
Max deductible	$545	$590
Coverage gap ('donut hole')	Still applied	Eliminated
Annual out-of-pocket cap	None (~$8,000 catastrophic entry)	$2,000 hard cap
Monthly payment option	Not available	Medicare Prescription Payment Plan available
Insulin cap	$35/mo	$35/mo (kept)

Example costs

Same person, different plans — this is why the annual re-shop matters.

Metformin + lisinopril only

$0–$15/mo premium

~$100–$250/yr all-in

Eliquis + 3 generics

$25–$60/mo premium

~$1,200–$2,000/yr — hits $2,000 cap

Insulin + specialty drug

$35–$85/mo premium

Caps at $2,000 out-of-pocket in 2025

Ranges are typical 2025 examples for illustration only — request a personalized quote for exact pricing.

Common questions

What if I take zero medications?

You still want the cheapest compliant Part D plan to avoid the permanent late-enrollment penalty. We enroll you in the lowest-cost plan available so you're covered if something changes and never trigger the penalty.

When can I switch Part D plans?

During Annual Enrollment (Oct 15 – Dec 7) for a January 1 effective date. Special Enrollment Periods also apply for moves, losing other coverage, plan terminations, and other qualifying events.

What is the 'donut hole' or coverage gap?

It's largely gone in 2025. The new $2,000 out-of-pocket cap replaced the old coverage gap structure — once your out-of-pocket costs reach $2,000, covered drugs are $0 for the rest of the year.

Do all pharmacies charge the same on my plan?

No. Most plans have 'preferred' pharmacies with lower copays than 'standard' network pharmacies. Choosing the wrong pharmacy on the right plan can double your annual drug cost.

Can I use mail order for a 90-day supply?

On most plans, yes — and it's usually cheaper than a 30-day retail fill. We factor that into your annual cost comparison.

Ready for a real answer?

A licensed independent broker — no cost, no pressure.

Find my best Part D plan →Contact Logan →

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