Prescription drug plans
Part D is priced around your medication list
Two people can look at the same plan and get completely different value from it. The difference is what’s in their medicine cabinet.
How Part D works
You can get drug coverage either as a standalone Part D plan alongside Original Medicare, or bundled into a Medicare Advantage plan.
Each plan publishes a formulary — the drugs it covers and the tier each one sits on. Tiers determine your share of the cost. Plans also have preferred pharmacies, where the same prescription can cost meaningfully less than down the road.
Formularies change every year. A plan that was ideal for you this year can become the wrong plan in January without you doing anything at all, which is the single best argument for an annual review.
What we check
- Every prescription you take, with dosage
- Which tier each drug sits on, per plan
- Whether prior authorization or step therapy applies
- Whether your pharmacy is preferred, standard or out of network
- The total projected annual cost, not just the premium
The late enrollment penalty
If you go without creditable drug coverage after you’re first eligible, Medicare adds a penalty to your Part D premium — and it stays for as long as you have coverage.
This catches people who take no medication at 65 and reasonably conclude they don’t need a drug plan. A low-cost plan now is usually cheaper than the penalty later, and it protects you if a prescription becomes necessary.
If you have drug coverage through an employer or a retiree plan, check whether it’s considered creditable. Most plans tell you in writing once a year.
Bring your prescription list
Names and dosages are enough. We’ll run it against every plan in your county and show you the total annual cost, not just the premium.