Medicare Part D — Prescription Drug Coverage Made Clear

Get help choosing the right drug plan so you can keep your medications affordable and avoid costly penalties.

What Is Medicare Part D?

Medicare Part D is prescription drug coverage designed to help pay for outpatient medications not covered by Original Medicare.

You can get Part D as a standalone plan if you have Original Medicare (Parts A & B ), or it may be included in a Medicare Advantage plan (Part C).

Each Part D plan is offered by private insurance companies approved by Medicare and comes with its own list of covered medications (called a formulary).

What Does Medicare Part D Cover?

Medicare Part D plans generally cover:

• Many brand-name and generic outpatient prescription medications
• Medications grouped into tiers (lower tiers usually cost less)
• Drugs purchased through preferred pharmacies (may offer lower copays)

Important

Each plan has its own formulary — not all medications are covered equally. I can help you check if your medications are covered before you enroll.

What Are the Costs for Part D?

Costs in Part D vary by plan and location. You may see:

• Monthly premium: Varies depending on your chosen plan
• 2026 annual Part D deductible: Up to $615; some plans have a lower or no deductible. The maximum is $700 for 2027.
• Co-pays and coinsurance: Varies based on drug tier and pharmacy choice
• Covered Part D out-of-pocket drug spending is capped at $2,100 in 2026 ($2,400 in 2027). After reaching the cap, you pay $0 for covered Part D drugs for the remainder of the year. The former coverage gap ended in 2025. Premiums and uncovered drugs do not count toward this cap.

These terms can be confusing — I help simplify your cost breakdown and find the plan that works for your prescriptions and budget.

When Should You Enroll in Part D?

You should enroll in Medicare Part D when you’re first eligible for Medicare (around age 65) unless you have creditable drug coverage elsewhere.

If you delay without other coverage, you may face a lifelong late enrollment penalty.

There are specific periods when you can enroll or make changes:

• Initial Enrollment Period: Starts three months before you turn 65 and lasts seven months.
• Annual Election Period: October 15 – December 7 each year.
• Special Enrollment Periods: If you lose other coverage or move.

Choosing the Right Part D Plan

When choosing a Part D plan, consider:

• Your current medication list — make sure your drugs are covered
• Your preferred pharmacies — costs can vary greatly
• Monthly premiums and potential out-of-pocket expenses

I will personally review your medications and help you compare plans so you can avoid unnecessary costs and surprises.

Part D and Medicare Advantage: How Do They Work Together?

If you choose a Medicare Advantage plan that includes drug coverage, you do not need a separate Part D plan.

If you have Original Medicare and a Medigap plan, you generally need a standalone Part D plan to cover your prescriptions.

This decision can be confusing — I can help you understand what makes sense for your health needs.

Get Help Choosing Your Medicare Drug Plan

The right prescription coverage helps protect both your health and your wallet. Javier Alvarez, your local Medicare advisor, can help you compare Part D plans, avoid penalties, and feel confident in your choices.