Prescription Drug Plans

How Do Prescription Drug Plans Work?

Annual Deductible — Most Part D plans have a deductible. In 2026, the maximum deductible is $615, although some plans may charge less — or none at all. You’ll pay the full cost of your covered medications until you meet your deductible.

Initial Coverage — After your deductible is met, your plan begins to share the cost. You’ll pay a copay or coinsurance based on your plan’s drug list (formulary). Drugs are grouped into tiers — such as generics, preferred brand-name drugs, and specialty medications — and each tier has a different cost.
You stay in this stage until your total out-of-pocket costs reach $2,100 in 2026.

$0 Coverage for the Rest of the Year – Once you’ve spent $2,100 out of pocket on covered prescriptions, you’ll pay nothing ($0) for covered Part D drugs for the rest of the calendar year.

Good News:

The old “donut hole” or coverage gap no longer exists. Medicare Part D now has a true annual cap on what you pay.

How would I enroll?

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Coverage options vary by eligibility and provider.