Medicare Part D
Medicare prescription drug coverage.
Medicare Part D
Medicare offers prescription drug coverage (Part D) to everyone with Medicare. Medicare Part D plans are offered by private companies to help cover the cost of prescription drugs. Everyone with Medicare can get this optional coverage to help lower their prescription drug costs.
Medicare Part D covers both brand-name and generic prescription drugs at participating pharmacies. Each Part D plan has a formulary — a list of medications the plan will cover.
Two Ways to Get Medicare Drug Coverage
Medicare Prescription Drug Plans (PDPs)
These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
- Standalone prescription drug coverage
- Works with Original Medicare
Medicare Advantage Plans (MA-PDs)
Medicare Advantage Plans (like an HMO or PPO) that offer Medicare prescription drug coverage. You get all of your Part A, Part B, and Part D coverage through these plans.
- All-in-one coverage
- Often includes extra benefits
Who Can Enroll in Medicare Part D?
To join a Medicare Prescription Drug Plan, you must have Part A and/or Part B. If you would like to get prescription drug coverage through a Medicare Advantage Plan, you must have Part A and Part B. You must also live in the service area of the Medicare drug plan you want to join.
Important Note for Medicare Beneficiaries with Employer or Union Coverage:
If you have employer or union coverage, call your benefits administrator before you make any changes. If you drop your employer or union coverage, you may not be able to get it back.
How Medicare Part D Plans Work
Part D plans may have a monthly cost and a yearly deductible. These vary from plan to plan. You pay a portion of your drug costs, including a copayment or coinsurance. Costs vary depending on which drug plan you choose.
2026 Standard Benefit Parameters
| Parameter | 2025 | 2026 |
|---|---|---|
| Deductible | $590 | $615 |
| Maximum Out of Pocket (MOOP) Threshold | $2,000 | $2,100 |
Extra Help (Low Income Subsidy)
If you have limited income and resources, you may qualify for Extra Help to pay for your prescription drug premium and costs. Extra Help can save you thousands of dollars each year.
2026 LIS Beneficiary Cost-Sharing
| LIS Level | Max Deductible | Generic / Brand Copay |
|---|---|---|
| Full Subsidy (Institutionalized/FBDE) | $0 | $0 / $0 |
| Full Subsidy (Up to 100% FPL) | $0 | $1.60 / $4.90 |
| Full Subsidy (100-150% FPL) | $0 | $5.10 / $12.65 |
To find out if you qualify for Extra Help, contact:
- 1-800-MEDICARE (1-800-633-4227) | TTY: 1-877-486-2048
- Social Security Administration: 1-800-772-1213 | TTY: 1-800-325-0778
Avoid the Late Enrollment Penalty
Even if you don't take a lot of prescription drugs now, you should still consider joining a Medicare drug plan. If you decide not to join a Medicare drug plan when you are first eligible, and you don't have other creditable prescription drug coverage, you will likely pay a late enrollment penalty (higher premiums) if you join later.
Note: Discount cards, doctor samples, free clinics, drug discount websites, and manufacturer's pharmacy assistance programs are not considered creditable coverage.
When Can You Enroll?
Annual Enrollment Period (AEP)
October 15 - December 7 each year
Initial Enrollment Period (IEP)
When you first become eligible for Medicare (7-month window around your 65th birthday)
Open Enrollment Period (OEP)
January 1 - March 31 each year. If you have a Medicare Advantage plan, you can switch plans or return to Original Medicare and add a standalone Part D plan.
Special Enrollment Period (SEP)
During certain life events (moving, losing coverage, qualifying for Extra Help, etc.)
Understanding the Formulary
Each Part D plan has a formulary — a list of medications the plan will cover. This list may also be referred to as a drug list, prescription drug list (PDL), or a covered medications list (CML).
Drug coverage varies from one plan to another, so if you are considering a Part D plan, review the plan's Prescription Drug List to be sure it will meet your needs.
For More Information
Contact Medicare
- 1-800-MEDICARE (1-800-633-4227)
- TTY: 1-877-486-2048
- 24 hours a day / 7 days a week
Online Resources
Find the Right Part D Plan for You
Our licensed agents can help you compare Part D plans and find the best coverage for your prescription needs.
Compare Part D Plans