Frequently asked questions

Medicare Part D is the part of Medicare that helps cover the cost of prescription drugs. It's offered by private insurance companies approved by Medicare and is available to anyone with Medicare Part A or Part B. Learn more →

It's generally recommended to enroll when first eligible. If you delay and don't have other creditable drug coverage, you'll face a permanent late enrollment penalty. Some plans cost as little as $0/month. Learn about the penalty →

The coverage gap (or "donut hole") was effectively eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic coverage. Once you reach $2,100 in out-of-pocket costs in 2026, you pay $0 for covered drugs. Read more →

Costs include a monthly premium (varies by plan), a possible annual deductible, and copays or coinsurance at the pharmacy. The out-of-pocket cap is $2,100 for 2026. See the full cost breakdown →

Every Part D plan publishes a formulary — a list of covered drugs. You can check a plan's formulary on its website or use a plan comparison tool. Compare plans on PlanMatch.com →

You can enroll during your Initial Enrollment Period (around your 65th birthday), the Annual Open Enrollment (October 15 – December 7), or a Special Enrollment Period triggered by a qualifying life event. Full enrollment guide →

Yes. You can switch plans during the Annual Open Enrollment period (October 15 – December 7). Special Enrollment Periods also allow changes if you have a qualifying life event. If you receive Extra Help, you can change plans once per month. Learn more →

Extra Help (also called the low-income subsidy) is a program that helps people with limited income pay for Part D premiums, deductibles, and copays. Some people qualify automatically. Check eligibility →

Part D plans must cap your cost for a one-month supply of covered insulin products at $35 or less. You don't need to meet your deductible first. This benefit applies to all Part D enrollees. Learn more →

Key changes include the out-of-pocket cap rising to $2,100, 10 drugs with new Medicare-negotiated prices, automatic M3P re-enrollment, and more plans with deductibles. See all 2026 changes →

If you go without Part D or creditable drug coverage for 63+ days and enroll later, you'll pay a permanent penalty added to your monthly premium. The penalty is 1% of the national base premium for each month you went without coverage. Calculate the penalty →

Standalone Part D plans only cover drugs and work with Original Medicare. Medicare Advantage plans (Part C) bundle hospital, medical, and usually drug coverage into one plan, but require you to use a provider network. Compare the options →

Most people can only change their Part D plan during the Annual Open Enrollment Period (October 15 – December 7), with changes taking effect January 1. However, certain situations allow mid-year changes through a Special Enrollment Period — for example, if you move to a new area, lose employer coverage, qualify for Extra Help, or are dual eligible for Medicare and Medicaid. If you're dual eligible, you can switch plans once per month. When you switch plans mid-year, your new plan's formulary, pharmacy network, and cost-sharing apply immediately — so check that your current medications are covered before making the change. Any out-of-pocket spending you've already accumulated toward the $2,100 annual cap carries over to your new plan. Learn more about switching plans →