Medicare Part D provides prescription drug coverage for people with Medicare. It's available as a standalone plan (if you have Original Medicare) or bundled into most Medicare Advantage plans.
Do I Need Part D?
If you take prescription medications, Part D coverage can save you significant money. Even if you're currently healthy and take few or no medications, it's generally wise to enroll when first eligible — because late enrollment can result in a permanent penalty on your monthly premium.
How Part D Works
Part D plans use a formulary — a list of covered drugs — organized into tiers. Lower tiers generally have lower copays:
- Tier 1 — Generic drugs (lowest cost)
- Tier 2 — Preferred brand-name drugs
- Tier 3 — Non-preferred brand-name drugs
- Tier 4/5 — Specialty drugs (highest cost)
The Part D Deductible and Coverage Phases
- Deductible phase — You pay 100% of drug costs up to the deductible (up to $590 in 2026; $0 on many plans)
- Initial coverage phase — You pay your copay/coinsurance; plan pays the rest
- Catastrophic coverage — After a set out-of-pocket maximum, costs drop significantly
Extra Help (Low Income Subsidy)
If you have limited income and resources, you may qualify for Extra Help — a federal program that reduces your Part D costs significantly. Call us to find out if you qualify.