Medicare Part D Prescription Drug Plans

Compare drug coverage using your prescriptions, pharmacy, and estimated yearly costs. Medicare Universe helps people in Arizona, New Mexico, and California understand their options before enrolling.

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Guidance from Scott Lavit, licensed insurance agent. No obligation to enroll.

What is Medicare Part D?

Part D is Medicare prescription drug coverage offered by private insurance companies approved by Medicare. A plan’s covered-drug list, called a formulary, determines which medications it covers and under what rules.

Original Medicare + a drug plan

A standalone Part D plan can work alongside Original Medicare. You need Part A and/or Part B to join, plus the plan’s service-area and eligibility requirements. Medicare Supplement policies sold today do not include Part D.

Medicare Advantage with drug coverage

Many Medicare Advantage plans include Part D. You need both Part A and Part B for Medicare Advantage. Review medical providers and drug coverage together when comparing these plans.

Check your current coverage first. Joining a standalone Part D plan while enrolled in a Medicare Advantage HMO or PPO generally disenrolls you from Medicare Advantage and returns you to Original Medicare. Employer and retiree benefits may also be affected.

How to compare Medicare drug plans

The best fit depends on your medications and where you fill them. A low monthly premium can still come with higher prescription expenses.

On a phone, swipe the table to see every column.

Prescription drug plan comparison checklist
What to check	Why it matters
Exact prescriptions	Use each drug’s name, strength, form, quantity, and refill frequency. Similar names or different dosages can produce different results.
Formulary and drug tier	Confirm coverage for every medication. The tier helps determine your copay or coinsurance; not every plan uses the same tier structure.
Coverage requirements	Look for prior authorization, step therapy, and quantity limits. A covered drug can still have requirements before the plan pays.
Your pharmacy location	Compare preferred and standard network pharmacies, including your specific store. Check retail and mail-order options rather than assuming one is cheaper.
Estimated total yearly cost	Compare premiums plus projected prescription spending. Review the month-by-month estimate, not just the annual total.

If a medication is not covered, your prescriber may help request a formulary exception or discuss an appropriate alternative. Approval is not guaranteed. Out-of-network pharmacy coverage is limited.

Medicare Part D costs and annual spending protection

Your costs may include a monthly premium, deductible, and copayments or coinsurance. Higher-income beneficiaries may owe an additional income-related Part D amount. Some plans do not apply a deductible to every drug tier.

On a phone, swipe the table to see every column.

Part D cost limits by calendar year
Cost limit	2026	2027
Maximum allowed Part D deductible	$615	$700
Annual out-of-pocket threshold for covered Part D drugs	$2,100	$2,400

A plan can have a lower deductible. Once qualifying out-of-pocket spending reaches the annual threshold, you pay $0 for covered Part D drugs for the rest of that calendar year. Premiums, noncovered drugs, and Part B drug expenses are outside this protection.

Extra Help

This program helps eligible people with limited income and resources pay Part D costs. Some qualify automatically; others apply through Social Security. Eligibility limits change, so check current requirements.

Medicare Prescription Payment Plan

This voluntary payment option spreads covered Part D out-of-pocket expenses across the calendar year. It does not lower your total drug costs. Premiums stay separate, and monthly bills can vary.

Certain outpatient medications are covered under Part B rather than Part D, depending on the drug and how and where it is provided.

When can you enroll or change Part D plans?

When first eligible: Your Initial Enrollment Period provides an opportunity to choose drug coverage.
October 15–December 7: Medicare Open Enrollment generally lets you join, drop, or switch drug plans for January 1.
After a qualifying event: A move or loss of certain coverage may create a Special Enrollment Period. The deadline depends on the event.

Generally, going 63 consecutive days or more without Part D or other creditable prescription coverage after your applicable enrollment period can trigger a late enrollment penalty. Creditable means the coverage is expected to pay, on average, at least as much as standard Medicare drug coverage. The 63-day rule is not an enrollment window.

Keep your employer’s creditable-coverage notice. Review your plan’s Annual Notice of Change every fall because premiums, formularies, and pharmacies can change.

Medicare Part D questions

Do I need Part D if I do not take prescriptions?

Consider future coverage and the potential late enrollment penalty. Having no current prescriptions does not exempt you from the penalty rules. Other creditable drug coverage may allow you to delay Part D.

Does Plan G or Plan N include prescription coverage?

Medicare Supplement policies sold today do not include Part D. Many people pair Original Medicare and a supplement with a separate drug plan. See our Plan G guide and Plan N guide.

Can I switch a standalone drug plan during January–March?

The Medicare Advantage Open Enrollment Period is for people already in Medicare Advantage. It does not give someone with Original Medicare a general opportunity to switch standalone Part D plans. A separate qualifying Special Enrollment Period may apply.

What should I prepare for a review?

Have your ZIP code, current coverage, exact medication list, preferred pharmacies, and planned coverage date ready. Start with the contact form; Scott can explain the next steps for sharing plan details.

Compare coverage around your actual prescriptions

Whether you use a neighborhood pharmacy in Phoenix, Albuquerque, or California, the specific location and medication list matter. Request help reviewing available coverage, costs, and enrollment timing.

Request a personalized plan review

Medicare Universe is a non-government entity and is not affiliated with or endorsed by Medicare or the U.S. government. Licensed in Arizona, New Mexico, and California.

Official resources

Information checked November 8, 2026. Benefits, costs, availability, and enrollment rights can change. Policy and plan documents govern coverage.