Medicare Part D (Prescription Drug Plans)
Because staying healthy shouldn’t break the bank.
Medicare Part D helps cover the cost of prescription medications — from everyday maintenance drugs to more specialized treatments. It’s available through private insurance companies that are approved by Medicare.
Whether you take a few prescriptions or many, having drug coverage can protect your health and your wallet.
How to Enroll in Medicare Part D
There are two main ways to get Medicare drug coverage:
- Enroll in a stand-alone Part D plan if you have Original Medicare (Parts A & B)
- Choose a Medicare Advantage plan that includes drug coverage (most do)
Not sure which route is best for you? We’ll help you compare plans based on your prescriptions and budget.
Understanding Drug Formularies
Each drug plan has a formulary — a list of covered medications — organized in tiers:
- Lower tiers include common, lower-cost generics
- Higher tiers include brand-name and specialty drugs
Plans can vary significantly, so it’s important to check that your medications are covered and understand what they’ll cost at the pharmacy.
A great tool to use is the Medicare Plan Finder on Medicare.gov — or reach out to us and we’ll walk you through it personally.
How Part D Coverage Works: 2025 Overview
Part D plans are structured into coverage stages based on how much you and the plan have paid for your medications. Here's a simple breakdown:
Stage 1: Annual Deductible
- You may pay up to the plan’s deductible amount before coverage begins.
- Some plans have no deductible, especially for lower-tier drugs.
Stage 2: Initial Coverage Period
- After your deductible is met, you and your plan share the cost of your prescriptions.
- Once your total drug spending (premium + drug cost) hits $2,000 in 2025, you move to Stage 3.
Stage 3: Catastrophic Coverage
- Once your out-of-pocket costs reach $2,000, you pay $0 for covered drugs for the rest of the year.
Note: These thresholds are subject to change each year.
Don’t Delay — Avoid the Part D Penalty
If you don’t sign up for Part D when you’re first eligible, you may have to pay a late enrollment penalty — and it’s added to your monthly premium for life.
The exception: If you have creditable drug coverage (like through an employer or union), you can delay without penalty. But once that coverage ends, you have 63 days to enroll in Part D.
Need Help Paying for Medications?
If your income and resources are limited, you may qualify for Extra Help, a federal program that helps pay:
- Your monthly premiums
- Annual deductibles
- Copays at the pharmacy
Most people who qualify for Extra Help pay little to nothing for their medications. To see if you qualify, contact Social Security at 1-800-772-1213 or visit SSA.gov.
We'll Help You Find the Right Plan
Every drug plan is different — and the one that’s right for your neighbor may not be the right one for you. At Tailored Medicare, we’ll help you find a Part D plan that covers your medications at the lowest possible cost.
for a free, no-pressure consultation. We’ll help you feel confident in your coverage — one prescription at a time.