Plans & Coverage
Part D Prescription Drug Plans
Medicare Part D covers prescription drugs. You can get it as a standalone plan (with Original Medicare or Medigap) or built into a Medicare Advantage plan. For 2026, Part D includes an annual out-of-pocket cap of $2,100 (CMS, 2026) — once you reach it, covered drugs cost you $0 for the rest of the year.
How to choose
The cheapest premium is rarely the cheapest plan. What matters is whether your specific drugs are on the plan's formulary, what tier they're on, and the deductible. We run your prescription list against every plan to find your lowest total cost.
The 2026 $2,100 cap
The old 'donut hole' is gone. Once your out-of-pocket drug costs hit $2,100 in 2026 (CMS, 2026), you pay nothing more for covered drugs that year — major protection if you take expensive medications.
Questions, answered
What is the Part D late enrollment penalty?
If you go without creditable drug coverage after you're first eligible, a permanent penalty is added to your premium. Enroll on time or keep creditable coverage to avoid it — we'll check your dates.
Can I change Part D plans every year?
Yes. During the Annual Enrollment Period (Oct 15–Dec 7) you can switch Part D plans for the next year. We review yours each fall.
Do I need a standalone Part D plan if I have Medicare Advantage?
Only if your Medicare Advantage plan doesn't already include drug coverage (an MA-PD plan). Most Medicare Advantage plans bundle Part D in — check yours before buying a separate standalone plan, since some plans don't allow you to carry both.
What is a formulary tier?
Plans group covered drugs into tiers — typically preferred generic, generic, preferred brand, non-preferred brand, and specialty — with a different copay or coinsurance at each tier. The same drug can sit on a different tier (and cost differently) from plan to plan, which is why we run your exact prescription list against each plan's formulary.
Talk to a local La Crosse area advisor
Free, no pressure — we compare your options for you.